Funding Announcement: Small-Scale Pilots to Implement Principles of Patient-Centered Measurement. American Institutes for Research

Transcription

1 Funding Announcement: Small-Scale Pilots to Implement Principles of Patient-Centered Measurement JANUARY 2018

2 Contents Page I. Funding Opportunity... 1 a. Purpose... 1 b. Program... 2 II. Award Information... 4 a. Pilot Requirements... 5 III. Who Can Apply/Eligibility Information... 6 IV. How to Apply... 6 a. Key Dates and Deadlines... 8 V. Review Process and Scoring Criteria... 9 a. Selection Criteria... 9 VI. Contact Information VII. Additional Requirements Appendix 1: Strategies for Taking Action to Make Measurement Patient-Centered Appendix 2: Letter of Intent Instructions and Template Appendix 3: Additional Requirements Support for this program was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation. Funding Announcement ii

3 I. Funding Opportunity a. Purpose In a high-performing health care system, effective measurement drives progress toward better care, better health, and lower costs. The challenge comes when considering how to define effective measurement, and from whose perspective. As the field of health care measurement has evolved in scope and complexity, it has done so in ways that reflect researcher, clinician, payer, and policy maker priorities. As a result, there is a critical gap. Current measurement approaches are not patient-centered and often do not align with patient and family needs, preferences, and values. When this happens, organizations and policy makers run the risk of providing information that patients do not find relevant or useful when making health care decisions and overlooking opportunities to drive quality and safety improvements in ways that align with patients values. Ultimately, to reorient the health care system to center on patients needs, preferences, and values, we need measurement that reflects what matters to patients. Reorienting measurement to be patient-centered is a critical step toward reaching the true north of patient-centered care. Patient-centered measurement is health care measurement driven by patients expressed preferences, needs, and values that informs progress toward better health, better care, and lower costs. 1 It refers broadly to all health and health care-related measurement and involves partnering with patients to decide what we measure, how we measure it, how and to whom we report the information, and how we use the results. In this definition, the term patient refers inclusively to people who receive health care services, family members, and other informal caregivers. It is important to note that patient-centered measurement is not about assessing the patientcenteredness of care. It is about measuring health care quality, safety, value, outcomes, and patient experiences of care in ways that reflect or center on the needs and values of patients. Likewise, patient-centered measurement is not just about developing and using measures reported by patients, such as patient-reported outcomes (PROs). Rather, it involves considering the patient-centeredness of all measures (whether or not reported directly by patients) and for all aspects of measurement, including measure development, data collection, data reporting, and decisions about how measures are used. The question at the heart of patient-centered measurement is, how would health care measurement look different if it reflected what patients say they need and want? The five principles below address this question by outlining the essential elements and key characteristics of patient-centered measurement. 1. (2017). Principles for making health care measurement patient-centered. Prepared for Robert Wood Johnson Foundation, Gordon and Betty Moore Foundation, and California Health Care Foundation. Washington, DC: Author. Retrieved from Funding Announcement 1

4 Five Principles for Patient-Centered Measurement Patient-centered measurement is 1. Patient-driven: Patients goals, preferences, and priorities drive what is measured and how performance is assessed. 2. Holistic: Measurement recognizes that patients are whole people and considers their circumstances, life and health histories, and experiences within and outside of the health care system. 3. Transparent: Patients have access to the same data as other stakeholders and understand how data are used to inform decision making around care practices and policies. 4. Comprehensible and timely: Patients and other stakeholders get timely, easy-to-understand data to inform decision making and quality improvement. 5. Co-created: Patients are equal partners in measure development and have decision-making authority about how data are collected, reported, and used. b. Program Patient-centered measurement is a nascent field, and as such, promising practices for implementing the five principles outlined above have not yet been defined. There is an urgent need for experimentation and innovation to explore various approaches for implementing the principles and capturing lessons learned. With funding from the Robert Wood Johnson Foundation (RWJF), American Institutes for Research (AIR) is seeking proposals for small-scale pilots that demonstrate ways to implement the five principles for patient-centered measurement in real-world settings. AIR will award up to four, 18-month pilots with funding of up to $197,000 per pilot. AIR envisions these pilots as small-scale projects designed to try out approaches for implementing the patient-centered measurement principles. Unlike full-scale implementations or evaluations comparing a well-specified intervention to a control group or usual processes, these small-scale pilots will provide an opportunity to identify promising practices prior to implementation of a larger-scale effort. In funding these pilots, RWJF and AIR aim to encourage adoption of all five principles in health care measurement by facilitating patient partnership and catalyzing improvements to current measurement practices. The goals of this program are to identify lessons learned and promising practices across a range of implementation strategies and to build momentum for further innovation across a community of patient-centered measurement stakeholders. Specific Areas of Interest This program aims to fund pilots that address all five of the patient-centered measurement principles, although some pilots may focus primarily on two or three. The strongest proposals will incorporate elements from all five principles into the pilot project. Those that do not should provide a rationale for the narrower focus. At a minimum, pilot projects must address the patient-driven and co-created principles because without appropriate attention to these principles, it is unlikely that projects will succeed in driving change toward measurement that is truly patient-centered. Funding Announcement 2

5 Patient-driven projects demonstrate responsiveness to patients goals, preferences, and priorities including differences among patients as expressed by patients themselves. All pilot projects should demonstrate that the specific topic, issues being addressed, and intended project outputs are important and meaningful to patients. Pilot projects can accomplish this through a variety of mechanisms. For example, projects may cite and build on previous work in which patients articulated measurement priorities or needs, or they may conduct research to identify these needs as part of the pilot. They may explore ways to address differences among patients through flexible measurement approaches. Innovation and creativity are welcomed and strongly encouraged. The strongest proposals will include an ongoing process for meaningful patient partnership throughout the project, from initial design to dissemination of results, and will be flexible enough to be responsive to patient input as the project proceeds. Co-creation occurs when patients and other stakeholders actively partner to produce a mutually valued outcome. 2 An active partnership exists when decision-making authority is shared across all partners as they collaborate in determining the project priorities, approach, and process. 3 To ensure effective co-creation, all pilot projects should clearly define and support meaningful, ongoing project roles for patients. Patients involvement should begin during proposal development and continue through results dissemination. Project teams should be attentive to supporting active partnerships through orientation, education, training, or mentorship for patients as well as for other team members with limited experience in collaborating with patients. Co-creation can be demonstrated through a variety of mechanisms, but in all cases, patients should have a clear voice and the authority to help shape the project s aims and methods. 4 The strongest proposals will include patients in leadership or co-leadership positions on the project team. Note: In partnering with patients, it is important that projects benefit from an authentic and unfiltered patient voice. This means including individuals whose expertise is grounded by lived experiences in the health care system. Furthermore, patients are not a homogenous group. Rather, they are diverse in demographics, experiences, needs, perspectives, and values. To the extent possible, researchers should strive to ensure that patient representation in the project reflects the diversity of the patient population targeted or directly affected by the project. The AIR report, Principles for Making Health Care Measurement Patient-Centered includes additional discussion of each of the five principles. 2 Adapted from Prahalad, C. K., & Ramaswamy, V. (2004). Co-creation experiences: The next practice in value creation. Journal of Interactive Marketing, 18(3). 3 Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (February 2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), Useful references about building successful partnerships with patients include the PCORI Patient Engagement Rubric and recommendations from a 2017 RAND report on consumer engagement in the quality measurement enterprise. Funding Announcement 3

6 Pilot Project Plans Pilot projects must align with the definition of patient-centered measurement (see Section I). In addition, applicants should clearly identify how the project relates to and supports the implementation of the patient-centered measurement principles. Although we are not specifying any particular approach, we expect that most projects will fall into the following categories: Measure development, selection, or adaptation. Projects in this category will focus on developing new measure concepts that address gaps important to patients, as expressed by patients; adapting or refining existing measures to better reflect patient needs, preferences, and values; selecting measures most meaningful to patients within a particular focus area for inclusion in influential measurement programs; or developing approaches that integrate or combine existing measures in novel ways. Projects that propose to develop new measure concepts (including measure focus, type, population, accountable entity, data source, numerator and denominator) should provide a rationale for how existing measures do not meet patients needs, and ensure early and ongoing opportunities for patients to drive concept development. Within this category, ideas that implement the principles while addressing how to avoid exacerbating the over-abundance of existing measures in certain areas are strongly encouraged. Data collection. This category includes projects that will focus on identifying new data sources or new methods of collecting data to be used for measurement, including increasing the use of technology; augmenting existing data sources with additional patient-centered data; increasing the use of patient-generated or patient-reported data; or reducing data collection burden on patients and providers. Data reporting. This category includes projects that focus on improving the understandability, timeliness, and usefulness of measure reports for stakeholders, including patients; disseminating health care measurement data in ways that increase patient uptake and use of the information; or increasing transparency around how health care performance information is used to inform policy and practice. Measure use. This category includes projects that focus on increasing patient access and/or control over their personal health data; using measures in ways that align with patients priorities and needs; or creating incentives through measurement that lead to direct benefits for patients and that avoid additional harm, inconvenience, or expense. For reference, Appendix 1 includes some implementation ideas generated over the course of developing the principles. However, applicants should not feel limited to these ideas. Because the first steps toward more patient-centered measurement will require creativity and flexibility, we encourage innovation and experimentation. II. Award Information AIR anticipates awarding Up to four pilot projects, each lasting 18 months, including start-up, implementation, identifying lessons learned, and producing a final report Funding Announcement 4

7 Total value of no more than $197,000 per pilot a. Pilot Requirements All pilot projects must include at least one patient partner as a key team member. Patient-led teams are also encouraged. In funding these pilots, the Robert Wood Johnson Foundation and AIR seek to identify lessons learned that may be shared widely and support the spread of patient-centered measurement. To support this goal, pilot project teams must adhere to the following monitoring and reporting requirements: Monthly calls. Awardees will provide updates on their progress during monthly meetings with their assigned AIR liaison, who will also serve as a resource for pilot teams to discuss challenges and provide technical assistance, as needed. Cross-pilot learning community. Awardees must actively participate in a learning community convened by AIR to facilitate sharing lessons learned and promising practices among the four pilot project teams. The learning community will create a space for (a) sharing progress, challenges, and successes; (b) receiving support and limited technical assistance from AIR related to implementing the Patient-Centered Measurement (PCM) principles; and (c) generating lessons about how to implement the principles most effectively. Awardees must participate in a virtual kickoff meeting with other awardees during the first month of the 18-month period of performance and subsequently participate in quarterly learning community meetings to discuss challenges, identify lessons learned, and share promising practices. There will be seven virtual meetings in total. Awardees should be prepared to share materials or resources produced through the pilot with other teams. Quarterly narrative and financial reports. Awardees will submit brief quarterly narrative and financial progress reports. The reports should include accomplishments over the last three months, plans for the next three months, challenges experienced in the past three months and how they were addressed, anticipated challenges, and potential solutions. The report will also track cumulative labor and nonlabor expenses. Final reports. One month after the pilot period ends, awardees will submit final reports, reporting on their project methods, activities, and key findings. Reports will include reflections on patient partnership (e.g., facilitators and challenges to co-creation, the patient partner perspective, etc.), as well as observations about impact (e.g., lessons learned, sustainability and scalability of project). Budget Requirements Indirect costs are overhead expenses incurred by the applicant organization as a result of the project but that are not easily identifiable with a specific project. These administrative expenses are related to overall operations and are shared among projects and/or functions. Examples include executive oversight, accounting, grants management, legal expenses, utilities, and facility maintenance. Funding Announcement 5

8 Applicants may include up to a maximum indirect rate of 12% of all costs (personnel, other direct costs, and purchased services) associated with the project. However, if the purchased services category equals more than 33% of the total for personnel, other direct costs, and purchased services, applicants may include 12% indirect on personnel and other direct costs and 4% on purchased services. We recognize that the calculated indirect cost rates for some grantees may exceed the maximum allowed under this funding opportunity; however, we will not be able to cover indirect costs above the rates stated here. III. Who Can Apply/Eligibility Information Proposals may be submitted by any U.S.-based private sector organization, including any nonprofit or for-profit organization; any public sector organization, including any institution of higher education or college hospital or health care system; any laboratory or manufacturer; or any unit of local, state, or federal government. For-profit organizations must agree to waive any profit or fee for services. AIR encourages cross-sector project teams and the creation of partnerships that expand the boundaries of traditional working relationships in health care measurement. IV. How to Apply AIR will implement a two-step proposal process, beginning with a Letter of Intent (LOI), followed by an invitation to submit a full proposal for those applicants whose LOIs are most responsive to the funding announcement. More information about each of these stages is included below. Step 1: Letter of Intent Interested applicants should submit a Letter of Intent (LOI) signed by a duly authorized officer or representative of the applicant that briefly outlines a proposed pilot project using the LOI template (see Appendix 2; also available at The LOI should address the following: Patient-centered measurement principles (250 words): Succinct rationale for relevance of the pilot project to the patient-centered measurement principles, including how each principle will be implemented. Projects that do not address all five principles should provide a rationale for the narrower focus. At a minimum, the patient-driven and co-created principles should be addressed in all proposed pilot projects. Project summary (250 words): Brief description of proposed pilot project and its objectives. Note which aspect(s) of measurement (e.g., measure development, data collection, data reporting, or measure use) will be addressed and the proposed approach or methods. Highlight aspects of the project that are innovative and/or have the potential to advance the practice of patient-centered measurement. Funding Announcement 6

9 Patient partnership (250 words): Describe how the project will demonstrate patient partnership in measurement, including a description of the role of the projects patient partners. Project team (250 words): The names and roles of project team members and a brief description of how the team will work together. Also briefly include information about organizational support for the project. Total project costs (up to $197,000 over 18 months) Supplemental materials beyond the LOI will not be reviewed. LOIs may be submitted in Word or PDF format to PCMpilots@air.org. AIR staff and patient partners will review LOIs and invite full proposals from those applicants that are most responsive to the funding announcement. Step 2: Full Proposal AIR will notify all applicants to let them know if they have been invited to submit a full proposal. Invited applicants should use the proposal template, which will be available at Full proposal templates will be posted at the time proposals are invited. Proposals must be no more than 10 single-spaced pages (no smaller than 11-point font and 1- inch margins) and should Clearly state project objectives and expected outcomes. Discuss the significance of the proposed project to the practice of patient-centered measurement, including how each principle will be implemented. Describe how lessons learned from the pilot could be applied more broadly and how the project might be sustained, scaled up, or spread beyond the pilot, if successful. Highlight aspects of the project that are innovative. Describe the project plan, including key tasks and activities, approaches for accomplishing those activities, and a project timeline. Describe how any required data will be acquired or collected, and managed. Describe a plan for partnering with patients in the design and execution of the project, including partnering in the development of the proposal. Also, describe how the proposed pilot project addresses topics or issues that are important to patients, as stated by patients themselves. Include information about support to be provided to patient partners, such as orientation, education, training, or mentorship, to maximize their contribution. Information about financial support for patient partners should be included in the budget justification. Funding Announcement 7

10 Describe the role and relevant experience for each member of the project team. This may include lived experience, advocacy or volunteer work, and professional qualifications. Include any relevant past experience specifically with health care measurement or collaborative partnerships among patients and health care professionals. Include a plan for how the team will work together effectively. Briefly describe any past work by members of the team including prior collaborations that will inform the conduct of the proposed project. Full proposals must be submitted in Word or PDF format to PCMpilots@air.org. Applicants must include a cost proposal, using the budget and budget justification templates that will be available at Full proposal templates will be posted at the time proposals are invited. Funds may be used for Personnel costs (includes project director, principal investigator, scholar or fellow; project staff; administrative staff; other staff; and fringe benefits) Other direct costs (includes office operations, communications/marketing, travel, meeting expenses, polls and surveys, equipment, project space, and other, if applicable) Purchased services (includes consultants and contracts, if applicable) Indirect costs (see indirect rate restrictions under Pilot Requirements) The budget should include the total cost, broken down by each of these categories (personnel, other direct costs, purchased services, and indirect costs) and a narrative budget justification that provides detailed information about each budget line item. Complete instructions will be provided when full proposals are invited. Recognizing the significant time commitment and value that active patient partnership will bring to the pilot projects, AIR strongly recommends that applicants follow best practices 5 and compensate patients for their participation on project teams. This could be accomplished through providing stipends, paying patients as consultants, or hiring patients as temporary staff. Please include in the budget justification a clear statement about how patient partners will be compensated commensurate with their level of effort. a. Key Dates and Deadlines Thursday, January 18, 2018 All questions/inquiries concerning this funding announcement must be submitted by to PCMpilots@air.org no later than 12 p.m. Eastern Time (ET) on January 18, AIR does not guarantee responses to questions submitted after this time. 5 The Patient-Centered Outcomes Research Institute (PCORI) provides a useful framework on compensating patient partners, available at: Research-Partners.pdf Funding Announcement 8

11 Friday, January 19, 2018 at 1 p.m. ET Optional applicant information webinar. Registration is required. This webinar will focus on program goals and will include time for questions. Please visit the program s website ( for complete details and to register. Wednesday, January 31, 2018 by 5 p.m. ET Deadline for receipt of LOIs Friday, February 23, 2018 Expected date applicants will be notified if invited to submit a full proposal Early March, 2018, TBD Optional applicant web conference call for applicants invited to submit a full proposal. Registration is required. Invited applicants will receive an with complete details and registration information. Friday, March 30, 2018 by 5 p.m. ET Deadline for receipt of full proposals Friday, April 27, 2018 Expected notification of award June 1, 2018 Anticipated pilot project start date Cancellations. AIR reserves the right to cancel this funding announcement; accept or reject any and all proposals, in whole or in part, received in response to this funding announcement; waive or permit the cure of minor irregularities; and conduct discussions with all qualified or potentially qualified applicants in any manner necessary to serve the best interests of AIR. AIR also reserves the right, in its sole discretion, to award a subaward based on the written proposals received without discussions or negotiations. V. Review Process and Scoring Criteria AIR staff and patient partners will review and rate LOIs and invite full proposals from those applicants that are most responsive to the funding announcement. Full proposals will be evaluated and scored by a review committee reflecting the perspectives of patients and families, health system leaders, providers, purchasers, researchers, funders, and measurement experts. The review committee will make final decisions about which applicants to fund. AIR will not provide applicants with individual critiques of submitted LOIs or proposals. a. Selection Criteria LOIs will be reviewed using the following criteria (see Table 1). Funding Announcement 9

12 Table 1. LOI Review Criteria Criterion Program fit Innovation Proposed project Patient partnership Project team and organizational support Budget/cost proposal Description Relevance of the project to the patient-centered measurement principles and the definition of patient-centered measurement. Does the application address multiple principles, including at a minimum the patient-driven and co-creation principles? In general, applications that address all of the principles will be considered stronger than those that address only a subset of them. Does the application challenge and seek to shift current measurement approaches by utilizing novel methods, data, processes, or approaches? Is there potential for lessons learned from the pilot to inform the broader field of measurement? Clarity of objectives. Is the project feasible within the proposed timeframe and budget? Are there any concerns that the applicant has not provided a reasonable set of methodologically sound activities or approaches to achieve the stated objectives? Demonstrates commitment to substantive, sustained partnership with patients in the design, execution, and monitoring of the project. Degree to which the project addresses topics and issues that are important to patients as stated by patients themselves. Strength of team composition, clarity of team roles, evidence of sufficient organizational support, including support for patient partners. Is the proposed project budget within scope of the funding announcement? Does the level of funding requested seem reasonable given the project scope? Full proposals will be reviewed using similar criteria and will receive a weighted score based on each criterion (see Table 2). Table 2. Full Proposal Review Criteria Program fit Innovation Criterion Description Weight Relevance of the project to the patient-centered measurement principles and the definition of patient-centered measurement. In general, applications that address all of the principles will be considered stronger than those that address only a subset of them. Is there potential for lessons learned from the pilot to inform the broader field of measurement? Does it have potential to be sustained, scaled up, or spread beyond the pilot, if successful? Does the application challenge and seek to shift current measurement approaches by utilizing novel methods, data, processes, or approaches? How well does the application propose an innovative idea that will advance the Patient-Centered Measurement (PCM) principles? Does the application include a clear rationale for how lessons learned from the pilot could help advance the practice of patient-centered measurement? 20% 10% Funding Announcement 10

13 Criterion Description Weight Project plan and timeline Patient partnership plan Project lead previous experience and project team capabilities Does the proposal lay out a clear plan for achieving project objectives? Are the objectives achievable given the project timeline and budget? Is the proposed approach methodologically sound? Are there any concerns that the applicant will not be able to deliver a successful project on time and within budget given potential challenges inherent in the proposed plan? Is there an adequate plan for engaging patients as partners in all aspects of the proposed project? Are the roles of patients significant in formulating the project s questions and design, and in the project s conduct and in the interpretation and dissemination of results? Does the application include orientation, education, training, or mentorship for patient partners as well as for other team members to enable meaningful partnership? Do the qualifications, time commitment, and role of the project lead align with the scope of work? Does the project team demonstrate sufficient experience with respect to quality or performance measurement? Are there any concerns about the project teams ability to work together collaboratively, particularly collaboration among patient partners and other team members? Budget/cost proposal How well does the application s proposed budget demonstrate reasonable cost allocations to complete the work? Are patient partners adequately compensated commensurate with their level of effort? 25% 25% 10% 10% VI. Contact Information Please direct inquiries to: Ellen Schultz, Project Director PCMpilots@air.org VII. Additional Requirements Applicants selected for awards must agree to comply with the additional requirements detailed in Appendix 3 upon their acceptance of an award. Funding Announcement 11

14 Appendix 1: Strategies for Taking Action to Make Measurement Patient-Centered While developing the principles for patient-centered measurement, AIR staff heard many ideas about how to make measurement more patient-centered. In this appendix, we summarize these ideas, mapping each suggestion to the most relevant patient-centered measurement principle (note, however, that many ideas span multiple principles). Although not fully developed into action plans or evaluated for feasibility, these ideas may help inspire additional innovation and action toward implementing the patient-centered measurement principles. Principle 1: Patient-Driven Patient goals, preferences, and priorities drive what is measured and how performance is assessed. Use innovative data collection methods that shift the focus to more patient-centric data sources. For example Leveraging technology to collect patient narratives or reviews Conducting and rating direct observations of care encounters Develop individualized performance and outcome measures that reflect patients goals, preferences, and priorities. For example Capturing patients goals in a care plan and assessing performance against these goals as measures of success at both the individual and population level Integrating patient quality of life measures into assessments of care quality and effectiveness Use community health assessments and community meetings or town halls to identify what aspects of health and health care matter to the community, then base measurement on these priorities. Expand the use of patient-reported outcome measures (PROMs), including adapting them for use as performance measures. Principle 2: Holistic Measurement recognizes that patients are whole people and considers their circumstances, life and health histories, and experiences within and outside of the health care system. Combine data sources (e.g., employers, schools, public health departments, and patientreported data) for a contextualized picture of health within communities. Shift the unit of accountability for measures to the whole care team, including the patient, rather than focusing on individual providers. Funding Announcement 12

15 Principle 3: Transparency Patients have access to the same data as other stakeholders and understand how data are used to inform decision making around care practices and policies. Provide patients with complete and open access to their personal health records and any associated data, including the ability to add information to and extract information from their medical records. Share data about the quality, safety, and cost of health care through town halls to educate and engage communities around health care measurement. Principle 4: Comprehensible and Timely Patients and other stakeholders get timely, easy-to-understand data to inform decision making and quality improvement. Develop user-friendly online applications that collect and report data in real-time. Collect and report patient data to better evaluate quality, safety, and patient experiences in real-time. Incorporate measurement, especially patient-reported outcome measures, into clinical care encounters. Principle 5: Co-Created Patients are equal partners in measure development and decision making about how data is collected, reported, and used. Partner with patients to consolidate competing performance measures, identify measurement gaps, and develop a national portfolio of best in class measures that address what matters to patients, as expressed by patients. Partner with patients during the development of new measures and the review or endorsement of existing measures. For example, include them on measure coordination and endorsement committees or employ them as paid consultants. Develop and implement training programs that cover key issues related to health care performance measurement to develop patient capacity and prepare them to engage in measure development and endorsement processes. Develop mechanisms that make it easier to identify and recruit patients to participate in measurement-related work. Mandate that a mix of professional and patient perspectives be included during measure funding, development, endorsement, and deployment, considering the need for diversity and inclusion in race/ethnicity, language spoken, age, sex, sexual orientation, gender identity and expression, geographic region, profession, education, income, and experience. Funding Announcement 13

16 Appendix 2: Letter of Intent Instructions and Template A Word version of this template may also be found at Funding Announcement 14

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20 Appendix 3: Additional Requirements Applicants selected for awards must agree to comply with additional requirements upon their acceptance of an award. 1. Use of grant funds a. No part of the grant shall be used to carry on propaganda or otherwise attempt to influence legislation within the meaning of Section 4945(d)(l) of the Internal Revenue Code. b. No part of the grant shall be used to attempt to influence the outcome of any specific public election or to carry on, directly or indirectly, any voter registration drive within the meaning of Section 4945(d)(2) of the Internal Revenue Code. c. No part of the grant shall be used to provide a grant to an individual for travel, study, or similar purpose within the meaning of Section 4945(d)(3) of the Internal Revenue Code, without prior written approval of AIR. Payments of salaries, other compensation, or expense reimbursement to subgrantee employees within the scope of their employment do not constitute grants for these purposes and are not subject to these restrictions. d. No part of the grant shall be used for purposes other than religious, charitable, scientific, literary, or educational purposes or the prevention of cruelty to children or animals within the meaning of Section l 70(c)(2)(B) of the Internal Revenue Code. If any portion of the grant is used for purposes other than those described in Section 170(c)(2)(B) of the Internal Revenue Code, subgrantee shall repay to AIR that portion of the grant and any additional amount in excess of such portion necessary to effect a correction under Section 4945 of the internal Revenue Code. e. Subgrantee promptly shall repay any portion of the grant which for any reason is not used exclusively for the purposes of the grant. Subgrantee shall repay to AIR any portion of the grant which is not used exclusively for the purposes described in Section I hereof by the expiration of the grant period or within any approved extension within thirty (30) days. f. Grantee agrees that any polls or surveys funded as part of this grant, if any, shall comply fully with the RWJF Guidelines for Funding and Releasing Polls and Surveys (which are available at 2. Accounting and audit. Subgrantee shall indicate the grant separately on subgrantee books of account. Subgrantee shall maintain a systematic accounting record of the receipt and disbursement of funds and expenditures incurred under the terms of the grant and shall retain the substantiating documents such as bills, invoices, cancelled checks, and receipts in subgrantee files for at least four (4) years after expiration of the grant period. Subgrantee agrees promptly to furnish AIR with copies of such documents upon AIR s request and to make subgrantee books and records available for inspection at reasonable times. Funding Announcement 18

21 3. Reports. Subgrantee shall furnish financial reports to AIR for each budget period of the grant and upon expiration, repayment, or termination of the grant. The financial report shall show actual expenditures reported as of the date of the report against the approved line item budget. Subgrantee shall furnish annual narrative reports and the final narrative report to us, which shall include a report on the progress subgrantee made toward achieving the grant purposes and any problems or obstacles encountered in the effort to achieve the grant purposes. All such reports shall be furnished to us within thirty (30) days after the close of the period for which such reports are made. Subgrantee shall retain all such reports in subgrantee files for at least four (4) years after expiration of the grant period. 4. Copyright. Subgrantee represents and warrants that the material produced by subgrantee under this grant will be original and not infringe upon any copyright or any other right of any other person, and has not previously been published. 5. Public reporting. The Foundation will report this grant, if made, in its next annual report. The Foundation will discuss potential communications activities with subgrantee related to this grant, including the issuing of press releases. Subgrantee shall not issue any press releases or any public announcements. In addition, the Foundation may publish reports on the project or program, briefly describing its accomplishments and results, which the Foundation may also use to respond to inquiries. 6. Certification required when grant may be used for research involving human subjects. If the grant is to be used in whole or in part for research involving human subjects, subgrantee hereby certifies that subgrantee will conduct the research in compliance with the ethical standards and the criteria for approval and conduct of research set forth in United States Department of Health and Human Services policy for the protection of human research subjects (45 C.F.R. Part 46 and related guidance, as amended from time to time) and all other federal and state laws applicable to the research project. Such requirements may include, but are not limited to, obtaining and maintaining institutional review board (IRB) approval and obtaining informed consent of participating research subjects. 7. Privacy and security of health information. Subgrantee represents and warrants that any individually identifiable health information used or disclosed in connection with the grant will be used and disclosed in compliance with applicable federal and state statutes and regulations regarding the privacy and security of such information including, but not limited to, the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. Section 201 et seq., as amended, and its applicable implementing regulations, 45 C.F.R. Part J 64 (HIPAA). Any health information reported to AIR will be de-identified within the meaning of the HIPAA privacy rule or will be consistent with the research subject s signed HIPAA authorization or will be otherwise permissible under law. Funding Announcement 19

22 About AIR is one of the world s largest behavioral and social science research and evaluation organizations. Our overriding goal is to use the best science available to bring the most effective ideas and approaches to enhancing everyday life. For us, making the world a better place is not wishful thinking. It is the goal that drives us. Founded in 1946 as a not-for-profit organization, we conduct our work with strict independence, objectivity, and nonpartisanship. The intellectual diversity of our 1,800 employees enables us to bring together experts from many fields in the search for innovative answers to challenges that span the human life course. About the Robert Wood Johnson Foundation For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit Follow the Foundation on Twitter at or on Facebook at Funding Announcement 20

23 ABOUT AMERICAN INSTITUTES FOR RESEARCH Established in 1946, with headquarters in Washington, D.C., (AIR) is an independent, nonpartisan, not-for-profit organization that conducts behavioral and social science research and delivers technical assistance both domestically and internationally. As one of the largest behavioral and social science research organizations in the world, AIR is committed to empowering communities and institutions with innovative solutions to the most critical challenges in education, health, workforce, and international development. LOCATIONS Domestic Washington, D.C. Atlanta, GA Austin, TX Cayce, SC Chapel Hill, NC Chicago, IL Columbus, OH Frederick, MD Honolulu, HI Indianapolis, IN Metairie, LA Monterey, CA Naperville, IL New York, NY Reston, VA Rockville, MD Sacramento, CA San Mateo, CA Waltham, MA International El Salvador 1000 Thomas Jefferson Street NW Washington, DC Ethiopia Haiti Honduras Kyrgyzstan Tajikistan Zambia 3314_01/18