FMMJUA Request for Applications

The Alvin E. Smith Safety of Health Care Services

Questions and Answers

Question:

Would the FMMJUA consider funding a project which devises primarily a series of educational interventions (educational monographs, live interactive seminars, podcasts, written materials, alerts, and public service announcements) for physicians, other members of the health care team, and patients?

Rather than a focus on eliminating a specific error or collection of errors commonly seen in hospital or surgical settings, the desired result of this education would be to eliminate the incidence of medical errors and poor patient outcomes in outpatient settings and between office visits based on lack of communication and patient understanding, poor coordination of care, inadequate documentation and recordkeeping. Education would include didactic instruction, coaching, sharing of templates and best practices to ensure effective communication strategies and collaboration, timely communication of test results, cultural competency, resourceful recordkeeping and use of technology for patient safety and continuity of care.

Answer:

Yes.

Section 1.4 of the RFA describes the funding opportunity as follows:

The objective of this RFA is for the FMMJUA to partner with agencies or institutions in the State of Florida to improve the safety of the delivery of health care services to patients by researching, developing, or implementing practices that eliminate or reduce medical errors, risk, hazards, or harms.

Later in section 1.4, the RFA provides that the proposed project should focus on one or more of three AHRQ Patient Safety Initiative elements. Element 2 provides:

(2) Teaching, Disseminating, and Implementing Effective Patient Safety Practices. Educate health care providers, purchasers, and patients; disseminate information to a variety of users; implement patient safety best-practices; raise awareness that patients are at risk for health care associated injury and harm; and adopt a positive patient safety culture.

The project described appears to “implement[] practices that eliminate or reduce medical errors, risk, hazards, or harms” and further “[e]ducate health care providers . . . and patients [and] disseminate information to a variety of users; implement patient safety best-practices; raise awareness that patients are at risk for health care associated injury and harm; and adopt a positive patient safety culture.”

Question:

Section 4.4 of the RFA refers to “…established indirect cost rate currently on file with a government agency (specify which government agency has established this rate).” Are you referring to federal or state government? Our federal rate is 47% and our state rate for indirect costs is 15%. Would either be allowed based upon your RFA?

Answer:

Yes.

Section 4.4 of the RFA, in describing the budget information to be provided by the Applicant, provides in part:

The Applicant must include in its Application a detailed budget for the proposed project. This budget should include a breakdown of all proposed expenditures. . . Include the sources, if possible, of any materials to be purchased using grant funds. At a minimum, the project budget should include expenditures for personnel (including fringe benefits), consultants, equipment, supplies, travel, materials, and other direct costs. An indirect cost may be included only if the applicant organization has an established indirect cost rate currently on file with a government agency (specify which government agency has established this rate).

The RFA allows the use of either cost rate. Provided a government agency has established the rate, it may be used in the RFA and the Budget Information portion of your application will be evaluated accordingly.

Question:

What type of organization is FMMJUA? Private, non-profit, etc.? What is the source of funding for this RFA?

Answer:

The FMMJUA was created by law (Section 627.351, F.S.) in 1975, for the purpose of affording reasonable medical malpractice insurance to Florida health care providers. The non-profit character of the Association provides that each policy year stands on its own and, under Rules promulgated by the Office of Insurance Regulation (“OIR”), surplus funds are refunded to policyholders, with certain conditions and limitations. The FMMJUA operates much like an insurance company. Premiums and investment income are used to pay claims and expenses.

The RFA is funded pursuant to the provisions of the Plan of Operation and Refund Plan, as approved by the OIR.

Question:

The RFA lists several conditions regarding intellectual property, indemnification, warranties, and the like. These are commonly negotiable matters for universities with grantors.  Will proposals be considered which identify these as conditions to be negotiated if awarded?

Answer:

Yes. The RFA contemplates a process by which the FMMJUA will negotiate the terms of the final grant agreement with a successful Applicant.  An Applicant may begin contract negotiations with the FMMJUA but ultimately not be chosen for funds if contract negotiations are unsuccessful. Note that the FMMJUA may choose one, more than one, or no Applicants to initiate contract negotiations in its sole and absolute discretion.

Section 1.2 of the RFA provides in pertinent part:

The FMMJUA reserves the right to waive any non-material deficiencies, if, in the judgment of the FMMJUA, its best interests will be served.

In addition, the FMMJUA reserves the right to . . . select for contract award or for negotiations an Application other than that with the lowest cost. The FMMJUA reserves the right to negotiate with some, all, or none of the Applicants with respect to any term or terms of the Applications or Contract.

An Agency or Institution responding to this RFA has no vested right to an award or other disposition of its Application because the Application is merely an offer by the firm that the Board, or a Committee acting on behalf of the Board, may in its sole discretion reject, using such criteria as it may determine.

Section 1.5 of the RFA further provides in part:

Grants awarded pursuant to this RFA will be funded according to a schedule appropriate to the particular project and will be negotiated with the successful Grantee.

Finally, section 5.4 of the RFA provides:

During contract negotiation, if the FMMJUA Board is unable to agree to contract terms with the Applicant receiving the highest evaluation in this RFA process, the Board reserves the right to terminate contract negotiations with that Candidate without undertaking another RFA process, thereby enabling the Board to negotiate with the Applicant receiving the next highest evaluation.

Question:

Section 1.6 of the RFA states that only one application may be submitted from an agency or institution. However, many healthcare organizations are actually made up of multiple separate corporations. For example, would the College of Medicine and College of Pharmacy at the University of Florida be considered two institutions, or the same institution?  Similarly, the UF College of Medicine has divided into two operations, one in Gainesville and one in Jacksonville, technically embodied in two separate corporations – would they be considered separate institutions for the purposes of this RFA, or one?

Given the diversity of interests and separate corporate structures here, it would seem that in both cases the intent of the RFA is best served by viewing these institutions as separate. In addition, the alternative view, which would result in only a single application being permitted from an entire University, would entail some internal competitive process for deciding which of several potential applications would be allowed to go forward.  There is no standing process for such decision, and given the short time frame for responding to the RFA, it is not certain that there would be sufficient time to prepare a credible proposal if it were contingent on an internal decision.

Answer:

Each entity that has a distinct Federal Employer Identification Number may submit one Application. In addition, the University of Florida College of Medicine and College of Pharmacy may each submit one Application as each is a distinct “organization.” The Jacksonville and Gainesville locations of the College of Medicine appear to be constituents of the same “organization” and hence may submit only one application between them unless each has a distinct Federal Employer Identification Number.

Section 1.6 of the RFA (“Eligible Applicants”) provides:

Any Agency or Institution in the State of Florida is eligible to submit an Application and receive funds under this RFA.  Applications shall be limited to one application per agency or institution.

“Institution” is defined in section 1.3 of the RFA as:

“Institution” means an established organization or corporation of a public character.

Section 4.4 of the RFA, in describing the requirements for Budget Information, provides in part:

The Agency or Institution Federal Employer Identification Number (FEIN) must appear on each budget page of the Application.

Any entity that has a distinct FEIN which will be used during the Grant may submit one Application, as the FMMJUA considers such an entity to be a distinct “organization or corporation.” In addition, on your specific facts, the University of Florida College of Medicine and College of Pharmacy are considered by the FMMJUA to each be an “established organization.” Therefore, the College of Medicine and the College of Pharmacy may each submit one Application.

Each physical location of the University of Florida, College of Medicine, is not considered by the FMMJUA to be a distinct “organization” because they are subject to the common control of the College of Medicine. Therefore the Gainesville and Jacksonville “operations” may submit only one Application between them (unless each has a distinct FEIN), recognizing that the two locations may jointly submit one Application for a single project in which program activities are undertaken at one location or both locations.

The RFA can be found on the website: www.fmmjua.com.