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COMPREHENSIVE PROGRAMS TO STRENGTHEN PHYSICIANS’

TRAINING IN GERIATRICS


CALL FOR PROPOSALS 2005-2006

 


 Deadline for receipt of mandatory letters of intent September 1, 2005

Deadline for proposal receipt January 9, 2006
 



 

The Donald W. Reynolds Foundation is an independent philanthropic organization incorporated in Nevada in 1954.  It is one of the fifty largest foundations in the United States.  Its benefactor was widely recognized as an entrepreneur, pioneer and dominant force in the American communications industry.

The Foundation’s Trustees have determined to bring its resources to bear in strengthening physicians’ training in geriatrics.  A demographic tidal wave of the elderly will soon sweep over the United States, thanks to the baby boom and life-extending medical, public health, economic and social advances.  It will pose extraordinary challenges for physicians as the number of frail elders more than doubles over the next thirty years.

Most physicians today lack adequate training to meet the needs of the frail elderly patient.  Such patients typically suffer from multiple, interactive physical and psychosocial conditions – both acute and chronic – that compromise their capacity to function in daily life and lessen their independence and quality of life.

Objective of Call for Proposals

The Reynolds Foundation now calls on America’s academic health centers to meet this challenge through comprehensive initiatives to strengthen the training in geriatrics of medical students, residents, and/or practicing physicians.

The Foundation solicits proposals for Comprehensive Programs to Strengthen the Training in Geriatrics of Medical Students, Residents and/or Practicing Physicians.  Of particular interest under this program are initiatives that are highly innovative and promise long-lasting, value-added impact.  Key to successful proposals will be a combination of commitment at an institution’s highest level to the program's goals, clearly defined objectives, and the availability of sufficient geriatric expertise to achieve those objectives.

Proposed activities may address any of the areas described below.  They should be sufficiently comprehensive to have a meaningful impact on a substantial number of medical students, residents and/or practicing physicians.  They should be aimed at developing knowledge of fundamental biomedical aspects of aging, geriatric assessment and care coordination and at training physicians to optimally manage the clinical conditions and special problems of the frail elderly.  Most important, these activities must lead to changes in training at the institution that will be maintained beyond Reynolds Foundation support. 

Possible Activities

Listed below are examples of activities applicants might choose to pursue with grant support.  They are not meant to be exclusive.  Other related possibilities may be considered.

An Enhanced Medical School Curriculum in Geriatrics.  This should include both pre-clinical and clinical preparation.  It could encompass a systematic modification of the curriculum, insertion of geriatric content into courses and clinical experiences, or the addition of specific mandatory courses or experiences in geriatrics.  One goal might be exposing students to a continuum of care for frail elders, including outpatient services, an inpatient hospital unit, teaching nursing home, home-based care, hospice and active rehabilitation service.  

Programs to Encourage Interest in Geriatrics among Medical Students.  These might include clubs, special meetings or training institutes, interest groups, student research programs, opportunities to work or meet with healthy elders, or simulations of elders’ health problems and care experiences.  All should be aimed at spreading enthusiasm among students for good care of older persons.

Strengthened Training in Geriatrics for Primary Care Residents.  This could encompass mandatory geriatric training in residency programs in internal medicine and family medicine.  Included would be changes in the curriculum or changes in the organization or role of preceptors to improve the availability to residents of geriatric expertise.  In all cases, the goal should be well-defined, substantial clinical and didactic experiences in geriatrics. Opportunities for meaningful participation in teams that include geriatric social workers, nurses and other health professionals are encouraged.

Strengthened Training in Geriatrics in the Medical and Surgical Specialties and the Subspecialties of Internal Medicine.  Proposals could meet the need to strengthen the geriatrics training of such internal medicine subspecialties as cardiology, gastroenterology, oncology, or nephrology or such specialties as gynecology, urology, psychiatry, surgery, orthopedics, or ophthalmology.    

Strengthening Practicing Physicians’ Geriatric Knowledge and Skills.  There is an urgent need for innovative approaches to continuing medical education in geriatrics for practicing physicians.  The goal should be to achieve substantial impact in preparing physicians to care for the frail elderly. 

Faculty Recruitment and Development.  Achieving an institution’s goals under this program may require augmenting its existing cadre of clinician-educators in geriatrics.  This might entail recruiting new clinician-educator faculty trained in geriatrics or training (and release time) for existing faculty, both in geriatrics and in relevant areas of curriculum development and education.

Development of New Educational Techniques and Methodologies.  This might include better ways of deploying scarce geriatrics expertise or employing innovative technology to make geriatric knowledge and skills more accessible, such as the use of CD ROMs, computer simulation, or the Internet. 

Infrastructure.  It is understood that a comprehensive initiative such as that sought under this program will require administrative leadership and support for which there is often a dearth of available funds.  Reasonable provision for this infrastructure may be included. 

Scale of Program and Individual Grants

The Reynolds Foundation expects to commit up to $20 million under this Call for Proposals. Up to ten grants will be awarded, each totaling up to $2 million (including indirect costs; see below) over four years, with a limit of $500,000 in each grant year.  This cohort, along with those receiving grants in April 2001 and July of 2003 will yield a total of up to 30 sites and a commitment totaling up to $60 million. 

Eligibility

The most successful applicants will be willing to initiate highly innovative and aggressive plans to strengthen geriatrics training for medical students, residents and/or practicing physicians.  They will demonstrate the availability of requisite competence in geriatrics, or a plan to establish that competence in time to produce results.  And they will offer evidence of long-term commitment to the program’s goals. 

The Foundation will accept proposals from U.S. medical schools accredited by the Liaison Committee on Medical Education (LCME) and residency programs in the United States accredited by Residency Review Committees associated with the Accreditation Council on Graduate Medical Education, provided those programs’ projects are proposed in collaboration with academic health centers.  Free-standing residency programs and continuing medical education programs are not eligible to apply. 

Academic health centers are encouraged to submit proposals that integrate, within a single project, the training of medical students, residents, and/or practicing physicians.  An academic health center may submit only one proposal for this 2005-2006 competition.

Proposals for collaborative projects involving more than one academic health center are not acceptable.

Requirements

Initiatives proposed in response to this invitation must meet the following requirements:

1.   The appropriate dean(s) and responsible officers, including relevant department chairs and program directors, must demonstrate their tangible commitment to the proposed activities and sign the proposal.

2.   The individual(s) responsible for the project must be included as an active participant in the dean’s council or its equivalent, the institution’s curriculum committee or its equivalent, and relevant department level equivalents. 

3.   Funds requested under the proposed grant must be matched for each of the four years of the grant:  one dollar from the grantee institution for every two dollars from the Foundation including the grant’s indirect cost provision.  Indirect costs will not be considered as matching funds.  (In the case of endowments, only the expended income generated by an endowment qualifies for the match.) 

4.   The grantee institution must pay at least half the total compensation of any individual for whom grant support is requested, regardless of the individual’s effort on this grant.      

5.   The grantee institution must commit itself to supporting grant-funded activities and positions beyond the grant’s termination.

Grant Selection Process

Grants under this initiative will be awarded on a competitive basis by the Foundation’s Trustees, taking into account the recommendations of an expert advisory panel.

The selection process will be in two steps.  The first step requires the submission of a full proposal, including the components described below.  Finalists will be selected based on a review of those proposals by the expert advisory panel.  In the second step, each Finalist institution will be invited to send three representatives to Las Vegas at Foundation expense to present its proposal to the expert advisory panel in a reverse site visit.   The advisory panel will then make its recommendations to the Foundation’s Trustees

            Timetable

A mandatory letter stating the institution’s intent to submit a proposal should be mailed to the Foundation by September 1, 2005.

Proposals must be received (not postmarked) by the Foundation by 5:00 p.m. Pacific Standard Time, January 9, 2006.  A signed original and nine copies of the proposal should be submitted.

Finalists will be notified no later than March 3, 2006.

Reverse site visits for Finalists will be scheduled March 27-30, 2006. 

Awards will be announced no later than June 1, 2006.

Grant-supported activities may commence on July 1, 2006.    

Letters of intent and proposals should be sent to:

The Donald W. Reynolds Foundation

Aging and Quality of Life Program

1701 Village Center Circle

Las Vegas, NV 89134-6303

For questions, contact Ms. Rani Snyder, the Senior Program Officer responsible for this initiative, at:

Telephone:   (800) 481-8780

Fax:            (702) 804-6035

E-mail:        rani.snyder@dwrf.org

Selection Criteria

The following major factors will be considered in the evaluation of proposals.  This list is intended to assist institutions in determining the appropriateness of candidacy.  All of the factors will enter into the consideration of proposals, though the relative weight given each may differ from case to case.  They are not listed in any specific order of priority.

  • The innovativeness of the proposed project.  New methodologies and curricula should focus on areas that have not been covered by existing Reynolds grantees.  Descriptions of the existing grants can be found at the Foundation Web site, www.dwreynolds.org/Programs/National/Aging/AboutAging.htm.  A list of the products that grantees have completed to date can be found at www.pogoe.org/inventory/ (beginning March 1).

  • The “value-added” of the project, as measured by the gap that will be filled between the institution’s current geriatrics training and projected project results.

  • The potential impact of the project in terms of the numbers of medical students, residents and/or practicing physicians who will be reached and the effectiveness of the training.

  • Demonstrated, tangible commitment of the institution’s leadership to strengthening training in geriatrics.

  • Strength and qualifications in geriatrics of those who will be responsible for leading and implementing the proposed project.

  • The quality of the institution’s existing general medical student, residency and continuing medical education programs. 

  • Institutional resources and unique facilities and technologies available to the proposed project.

  • A plan to evaluate the results of the program.

  • The extent and nature of the institution’s financial commitment to continuing project activities and personnel after the proposed grant’s termination. 

  • The appropriateness of the proposed budget.

Components of the Proposal

A proposal should not exceed 25 single-spaced pages in length, excluding biographical profiles, budget and IRS letter(s), and should include the following information:

  • A cover sheet that includes the name and address of the institution, title of the project, amount and term of the requested grant, the proposed date of project initiation, the name and contact information of the individual responsible for the project, and the appropriate signatures, as specified in Requirements, above.  

  • A one-page summary of the proposed project.

  • A detailed description, not exceeding four pages, of the institution’s existing medical student, residency and continuing education programs, in general,  and of the existing specific curriculum, courses and training activities related to geriatrics and to the groups targeted under the proposal for strengthened geriatrics training.

  • A detailed description, not exceeding 10 pages, of the activities proposed for grant support and their expected impact.

  • Additional background information deemed relevant by the institution.

  • A detailed description, not exceeding three pages, of an evaluation plan to measure the impact of the proposed activities, including comparison with meaningful baseline information. 

  • For applicants who have submitted proposals in previous competitions: a summary of the events that have occurred since your last application that have changed your environment or proposed activities.

  • Information, not exceeding three pages, on existing and proposed post-grant institutional financial support for the proposed activities and personnel.

  • A four-year timeline outlining proposed project activities.

  • Detailed budget and budget justification, using the instructions and format attached to this call for proposals.

  • Biographical profiles, not exceeding two pages each, of current faculty whose expertise in geriatrics would be tapped for the proposed activities and of other faculty who would participate in the project.

  • IRS letter(s) documenting the institution’s tax exempt status.

Indirect Costs and Fringe Benefits

The Foundation has established that a grantee institution under this program may receive an indirect cost rate of 20% of direct grant expenditures, excluding subcontracts.  Indirect costs may be paid to subcontractors but they may not exceed 20%.

Fringe benefits may not exceed the institution’s federally approved rate.

The grantee institution may not apply expenditures in excess of the above provisions for indirect costs and fringe benefits in calculating its match of grant funds.  

Expenditures Not Allowed under Grant Budget

  • More than half the amount of any individual’s salary and benefits.
  • Tuition costs or laboratory fees for work leading to an M.D. or Ph.D. (Special courses or other preparation in geriatrics, curriculum development, etc. are permitted for those holding the M.D. or Ph.D.).
  • Construction or renovation of buildings.
  • The cost of participation in and travel to scientific or educational conferences or meetings unless for purposes or activities directly and explicitly linked to specific project goals and activities. 
  • Items ordinarily considered to be overhead (i.e. lights, rent, office furniture, janitorial services, etc.) will be allowed only as part of the indirect costs provision.

Evaluation and Monitoring

Grants awarded under this program will be evaluated annually by Foundation staff and/or consultants.  Evaluation may entail site visits.  Grantees will be required to submit annual progress and expenditure reports. 

Liability

The Donald W. Reynolds Foundation is not responsible for any claim, judgment, award, damages, settlement, negligence or malpractice arising from training, research, or other activities related to an award.  The grantee institution must acknowledge responsibility for activities related to an award, and release the Donald W. Reynolds Foundation from all claims or liability that may arise from the conduct of such activities related to an award resulting from any act or omission on the part of the institution, its employees, agents or representatives. 

March 2005