REQUEST FOR APPLICATIONS NYS DEMENTIA GRANTS PROGRAM

INFORMATION MEETING

October 27, 2006

Krause Center

2212 Burdett Avenue

Troy, NY 12180

1:00 - 4:00 PM

TIMEFRAMES

• Letters of intent (11/10/06)• Application deadline (1/27/07)

NOTE DEADLINE CHANGE TO 1/27/07• Application review and scoring (2/07 -- 6/07)• Award announcement (8/07)• Contract assembly and execution

(8/07 - 11/07)• Contract start date and term (1/1/08 - 12/31/10)

WHO IS ELIGIBLE TO APPLY?

ONLY NYS Article 28 nursing homes are eligible to apply.

NHs that currently have dementia grant awards or have been awarded dementia grant funds in the past are still eligible to apply

SUB-CONTRACTORS

Applicants may sub-contract with other nursing homes, organizations, consultants, etc., and pay them grant funds.

AWARD CAPS

• Three year contracts

• Capped at an average of $300,00/year

• Total grant award cannot exceed $900,00

• Paid through an adjustment to your Medicaid rate.

• Same rate add-on for all three years

PROGRAM OBJECTIVES

1.Disseminate evidence-based best practices into NHs that have not yet adopted them such that the NHs sustain the best practice over time.

PROGRAM OBJECTIVES, Cont’d.

2.Develop an evidence-based best practice.

OPTIONAL DELIVERABLE

High quality training and implementation materials:– in-service training materials for all staff– implementation guidance– implementation documentation forms– etc.

CHANGE TO RFA: REQUIRED DELIVERABLE

Projects are required to participate and present in the biennial statewide dementia conference

EVALUATION

• Must be done regardless of which objective your application addresses

• Is worth 30 of the 75 technical points

• Is a critical component of your project

• Must focus on measureable resident outcomes

• Should include a solid CEA

MEASUREABLE RESIDENT OUTCOMES

– Required by the RFA– Application must make the case that the intevention

or best practice will produce the measureable resident outcomes

– May also measure staff and family outcomes– If resident outcomes are process measures, such

as number of ER or hospital visits, must still specify resident outcomes that address why such decreases are a desired outcome. For example, is there a decrease in infections and other preventable conditions?

RESIDENT SAMPLE

Can include only residents with dementia, although other residents can participate in the project

Clarification to RFA: a cognitive impairment screen can be used to identify residents who possibly or probably have dementia

SUGGESTED READING

• Journal of Clinical Epidemiology, 2006. Scaling the Mini-Mental State Examination using item response theory, J. Teresi.

• Neurology 54(4):827, February 22, 2000. Memory impairment on free and cued selective reminding predicts dementia. Grober, Ellen PhD; Lipton, Richard B. MD; Hall, Charles PhD; Crystal, Howard MD.

• Research on Aging 22(6), November 2000, 738-773. Applications of Item Response Theory to the Examination of the Psychometric Properties and Differential Item Functioning of the Comprehensive Assessment and Referral Evaluation Dementia Diagnostic Scale Among Samples of Latino, African American, and White Non-Latino Elderly. J. Teresi, M. Kleinman, K. Ocepek-Welikson, M. Ramirez, B. Gurland, R. Lantigua, D. Holmes.

MEASUREMENT ISSUES

• Determine resident outcome variables• Review the literature and select the best

measures for each variable• Review the data collection tool for each

measure• Determine required qualifications for those

who will collect the data for each measure• Train data collectors to pre-determined

standards on the data collection tools

INSTITUTIONAL REVIEW BOARD

• NHs whose projects require IRB review and approval cannot use the DOH IRB

• If approval is denied, the project cannot be funded

• If appropriate, structure your project as a quality assurance or quality improvement project

BUDGET AND ALLOWABLE COSTS

• Expenses already reimbursed through your Medicaid rate are not allowable

• Indirect rate - not allowed for nursing homes - must be itemized and justified

• Managing consortia and administering grant funds within a consortium

• IRB• Fixed and movable capital• Training materials

SCORING CRITERIA

Interventions that will result in lower scores:– weak or unclear causal relationship w/

resident outcomes – NHs wouldn’t implement absent outside

funding– will benefit very small sub-sets of the NH

population w/ dementia

SCORING CRITERIA, CONT’D

• Project and evaluation work plans

• Project and evaluation staffing

• Sustainability

PREFERENCE POINTS

• Up to 5 points for training and implementation materials

• Up to 5 points for consortium of facilities (i.e., NHs and ACFs)