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Ambulatory Safety and Quality
Technical Assistance Call
This document summarizes the technical assistance call for the Ambulatory Safety and Quality: Enabling Quality Measurement Through the Use of Health IT funding opportunity announcement (FOA). Select to access the FOA.
The technical assistance teleconference was held at the Agency for Healthcare Research and Quality (AHRQ) conference center in Rockville, MD, on January 4, 2007. If after reading this document you have any questions or comments, contact email@example.com.
Good morning everybody, or good afternoon for those of you on the east coast. This is David Meyers. I'm a Medical Officer at the Agency for Healthcare Research and Quality. And this is the first of our three technical assistance calls for our Ambulatory Safety and Quality FOAs.
This call is regarding the quality measurement. At 1:30 p.m., we'll have our call for patient-centered care, and at 3 o'clock, we'll start our call for the third FOA on improving quality of care through clinician use of Health Information Technology (Health IT).
Thank you all for joining us. I hope everyone out there has received a set of the slides. If you haven't, that's okay. We'll be posting them after the call, along with the transcript of the questions and any answers that we provide you today.
If we run out of time during today's call before the start of our next call, we're going to encourage you to continue to submit questions. And any questions submitted today, we will publish the answers along with the questions that were answered publicly.
Because we have a large group of over 100 today, we're not allowing you to ask questions during the session. But if you look at your slides, you'll see our agenda today.
I'm going to provide you with a brief overview of the larger program of which this FOA is a part, and then talk about some of the specifics of this FOA. We'll go through a few frequently asked questions that we've already received in advance. And at the end, we'll leave time for new questions from the audience, as well as those questions that have been pre-submitted to us.
At this time, I'm going to ask the staff here at AHRQ who are in the room and involved with this program to introduce themselves to you so you'll have some other voices to associate with the people you'll be talking with in the future:
Thank you, everybody.
So what you heard is that you have people in the room who are from the programmatic side, who are the content staff for this. You have people in the room to answer questions related to your application process, and what will happen from letters of intent through the review, and then some staff from our grants office, for those who are given awards, who you'll work with in future on budget and financial issues. So we'll cover all of those today.
We'll be following a set of slides today that was provided electronically before the call began: (PowerPoint® file, 110 KB; Text Version). Slide presentations can be accessed using a Free PowerPoint® Viewer.
Moving on to our slides, to the third slide, the AHRQ Ambulatory Safety and Quality Program consists of four FOAs with an overview, an umbrella to improve the safety and quality of ambulatory healthcare in the United States. And as you know, our country has spent some time improving quality and safety in the hospital setting, in the inpatient setting.
This announcement does not take away from that work but rather expands it, recognizing that there's complexity, increased scope, increased volume in ambulatory care. And so with this part of the initiative, we'll be focusing in that arena.
Additionally, this brings together two streams of work at AHRQ. We're thinking about quality and patient safety, and marrying that with the role that Health IT can play in this arena.
Next slide, the overall program for 2007 consist of four funding announcements. And in this call, we're talking about the fourth one, enabling quality measurement through Health IT.
Going on, for this announcement, it's important that you understand the definition we are using of ambulatory care. Traditionally, ambulatory care refers to all types of health services provided by healthcare professionals on an outpatient basis.
You'll see a list below of some of the settings that are included here. And I'd like to call your attention to the fact that the FOA notes that while home care is often not considered part of ambulatory care, for the purposes of this FOA, those of you who work in the home care arena are welcome to apply as part of ambulatory care.
Going on now to what this FOA's focus is, we are interested in projects that look at new methods or evaluate existing strategies for using Health IT to assist clinicians and healthcare systems to measure quality and safety in ambulatory care.
We're encouraging you to develop new safety and quality measures to:
At this point, I'm going to digress from the slides to remind you that all the words from these slides and everything we're talking about today is grounded in the actual writing of the FOA.
If at any time, anything I say or anyone in the room says contradicts what's in the FOA, you are now notified that descriptions in the FOA will supersede our statements provided here. We are just trying today to clarify what we've already put down on paper for you.
So moving on, the goals of this FOA are outlined for you. Again, developing safety and quality measures for ambulatory care, and then there are some specifics that you can read in the slide.
And I'll call your attention to the final part of this slide, which notes that while this FOA is generally focused on the marriage of Health IT into the quality and safety of ambulatory care, this FOA has a special set aside of $1.8 million for projects that are focusing on quality, which focus on quality and patient safety, although they do not involve the use of Health IT to do it.
Nonetheless, these projects are held to all of the same standards of fulfilling the objectives of the FOA in the ambulatory setting and across settings of care, and we'll talk at the end about what you need to do if you'd like to be considered for the special funding.
The next two slides are taken directly from the FOA and list the many areas of interests that AHRQ has in this field. Rather than go through them, they are here just to point out that we recognize that people may come in under this funding announcement in many different ways.
They range from the beginning of the process of identifying measures and determining them all the way through demonstrations of how, once these measures are implemented in practice, they actually result in improvement of care and all of the steps in between.
Think for a moment about what you need to do in your application as you read the next slide. You're expected to:
All of those aspects are required under this FOA.
I want to highlight that in the FOA, you will see under a section describing what we would expect under the specific aims, that when you describe your intervention, it is expected that some aspects of the intervention, for most applications, will include the use of Health IT. For those who are developing a new measure, it is important that the new measure will rely on electronic coded data from electronic health systems or from claims merged with EHR data. We'll talk a little bit more about some of that in a moment.
Flipping to the next slide, you'll see that if you are bringing in an application that involves Health IT, the use of American National Standards Institute (ANSI) Health Information Technology Standards Panel (HITSP) standards, where they exist, is required. And we expect that the application will detail your process for making sure that you've checked to see that if there are standards for the data elements you propose to use, those standards will be used when available, and what will happen over time if new standards are applied.
Additionally, we expect that people will employ existing measures of quality when they exist whether they've been developed or adopted by AHRQ, Ambulatory Care Quality Alliance (AQA), or Hospital Quality Alliance (HQA).
Turning to the next slide, some of the "musts" that you should remember:
Additionally, you must include a dissemination plan for your work. It must be included in the budget of your project. I would like to point out that it may be possible in the future that AHRQ will have additional funds available, on a limited competition basis, for people awarded grants under this FOA, to do additional dissemination work. However, your application cannot count on that funding for its dissemination plan. You must have a dissemination plan as part of your application.
The next slide describes required measures. In order to facilitate evaluation across projects in the AHRQ portfolios, AHRQ is requiring that all applicants measure and report on the following outcomes when appropriate to their project's specific aims.
There are five specific measures that we're requesting:
Moving on to some of the other fine print in the application, privacy and security is of utmost importance to AHRQ in this application. All applicants are required to describe how in both the development and the implementation of their intervention, privacy and security issues related to the exchange of scientific health information will be both identified and addressed.
And I call your attention to the larger section in the FOA that describes this. There's some very good language that explains to you what we mean by privacy and security, where you can go for more information and what types of things we'd expect to see in applications to meet this requirement.
Moving on, who is eligible to apply? You're eligible to apply if your organization is a public institution or a non-profit private institution. Those include non-profit healthcare organizations, universities, and faith-based and community organizations.
Additionally, units of State or local government who are eligible to apply for Federal funding are welcome as well as Indian and Native American tribal governments or their designated organizations. Specifically, for-profit organizations are not eligible to be the lead organization in an application. However, for-profit organizations may participate in projects as members of consortia or as subcontractors.
And for-profit organizations that produce Health IT systems are especially encouraged to apply in partnership with non-profit organizations in the lead.
Similarly, foreign institutions are not eligible to apply. However, they may be considered as members of consortia or as subcontractors.
The principal investigator must be identified in the application. There are a few other requirements detailed on the next slide.
I'll call your attention to the fact that we expect a considerable portion of the principal investigator's (PI's) time will be devoted to this project. If less than 20 percent of his or her time will be devoted, the application must include an explicit justification.
Moving on to the next slide, on funding considerations, you'll note that there are two sets represented in this page. The first is the scientific merit of the proposed project as determined by peer review. That's the aspect that you have the most control over, and we'll talk specifically about what the peer reviewers will be looking for. But you then can see there are several other factors that will go into funding decisions made by AHRQ, including the availability of funds, the relevance of projects to the larger portfolio, the balance of projects funded in the portfolio, as well as in larger HHS initiatives.
If you skip ahead two slides for a moment, there are the specific review criteria that this FOA includes:
Additional considerations are that the peer review group will assess how responsive you were to the goals of the FOA, your attention to privacy and security protection for all involved, the extent to which you have addressed the protection of human subjects from research risk and the inclusion of priority populations.
Going back now to the non-Health IT funding preference (this was mentioned earlier), you may specifically request to be considered for funding preference in an area of quality and patient safety that does not directly involve Health IT. Applicants requesting this consideration are exempt from the Health IT requirements and Health IT aspects of the review criteria for this FOA, but all other review criteria apply. Specifically, everyone applying under this FOA should include an Appendix 1, which either describes why you would like to be considered for funding under this funding preference or in which you state no funding preference requested.
Finally, for the last nitty-gritty things, this is an R18 mechanism which is for research demonstration and dissemination projects. And it's useful to note that the goal of this type of funding mechanism is to provide support designed to develop tests and evaluate health service activities.
This is a one-time solicitation. You should not expect—though it could be possible—you should not expect future re-release of this application. AHRQ plans to commit up to $6.8 million in FY '07 for this project. All projects can go up to a maximum of 24 months in duration. The budget is a total budget and may not exceed $1 million in total costs over the 24 months or less period. Total costs again include your direct and your indirect expenses. This is different from some other Federal funding agencies.
The budget for any single year may not exceed $500,000, again, in total costs. And we recognize and hope that projects will use that flexibility to apply for between 12 to 24 months of funding and for different funding amounts as well.
Flipping to the next page, AHRQ does not accept modular budgets. For those who haven't applied to AHRQ before, let me say it again, AHRQ does not accept modular budgets. We only use detailed research and related budgets. Do not use the PHS 398 or the 424 modular budget forms. Any application submitted in modular budget format will be returned without review.
As you heard, we have somebody here involved in the electronic application process. If you have questions about that, the SF 424 R&R must be used for this application and the application must be submitted electronically.
Please look at the FOA for instructions on how to obtain electronic forms you'll need and how to register both your institution and the principal investigator, all of which need to be accomplished before your application can be submitted. If you have not begun this process, it can take up to 6 weeks to register both your institution and then register the PI. And so that's important to get started on now.
On the next page, you'll see the key dates. An opening date for an FOA means the first date in which an electronic application can be submitted. That will be on January 13. We request a letter of intent be sent to AHRQ by January 19. You can submit them through email, by fax, or by regular mail.
All applications are due on February 13, 2007. We anticipate a peer review meeting in April or May of this year so that you should figure the earliest possible date for a successful application would be July 2007.
Moving on now, we have a few questions that have been asked in the past that we would like to address. We'll go through this quickly.
Questions and Answers
Question: Are hospitals allowed to apply?
Answer: Public and non-profit health care institutions, including hospitals, are eligible to apply. For-profit organizations, including for-profit healthcare organizations and Health IT vendors, can be included on applications as members of consortia or as subcontractors if the application is submitted by an eligible lead organization.
Question: Do we accept modular applications?
Answer: No. Enough said.
Question: Are emergency rooms considered ambulatory care sites?
Answer: For the purposes of this FOA, yes. Again, ambulatory care settings include healthcare clinician offices, both large and small practices, outpatient clinics, community health centers, emergency departments, urgent care centers, and ambulatory surgery centers. For the purpose of this program, home care entities are included as well and may apply as the lead organization.
Question: What if you're interested in focusing on the transition between health care settings?
Answer: The FOA specifically defines healthcare transition as the movement of patients between healthcare providers and settings as their conditions and care needs change during the course of a chronic or acute illness. This program includes a focus on transitions between ambulatory care settings and hospitals, assisted-living centers, and other non-ambulatory settings. We recognize that improving patient safety and quality during a transition is critical to the success of ambulatory care for many elderly and chronically ill populations.
Non-ambulatory institutions or those that represent settings with a strong interest in fostering safe, high-quality ambulatory care, and transitions are welcome to apply in partnership with an ambulatory organization.
Question: Can there be co-PIs?
Answer: No. AHRQ requires that the lead institution designate one and only one individual as the project's principal investigator. However, how you define the roles of the full team of people is up to the individuals in your application. But for the purpose of the FOA, one person must be designated as the principal investigator.
Okay, that brings us to the end of our prepared questions so we're going to move in to open questions from the audience.
Open Question Period for Conference Call Participants
I'd like to note that we have approximately ten questions that were submitted electronically previously. If your question wasn't answered on the slide so far and you've already listed your question, we have that and we'll try to go through them.
At this time, I'm going to ask the operator to come on to ask anybody who has a question to let us know now. Rather than going through question-answer, question-answer, what we're going to do now is get as many questions as we can.
All additional questions, we're going to ask that you supply them to us online at firstname.lastname@example.org. You can do that even while you're listening right now, and we will include the answers to those questions in the final transcript. But recognizing the time, we're going to go—we're just going to ask for questions and then we'll prioritize those combined notes and as a group, try to answer them for you.
Question: In the FOA, I noticed that in eligible organizations, it eliminates 501(c) 4s; my question is regarding trade associations with 501(c) 6s, are they eligible?
Answer: 501(c) 6 organizations are eligible. 501(c)4 organizations that lobby are not eligible.
Question: Would an application using non-coded Electronic Health Record (EHR) data be eligible?
Answer: And the answer in the FOA is yes, non-coded data may be used. However, the applicant should be aware that when HITSP standards exist, those standards must be used for data. In the application, applicants should describe the process of how they've identified what is non-coded and does not have a standard, how they're going to use and represent that data, what's non-coded, and then how they are going to apply HITSP standards where they exist.
Question: How much technical assistance is going to be available? It sounds like a lot may be needed.
Answer: For this period, this is the only formal technical assistance available and the questions and answers will be written and posted on the AHRQ Web site so that you can review what was said today. On the last page of the slide, as well as in the FOA, we have included specific people you may contact for clarification regarding budget matters, peer review matters, or an explanation of an unclear part of the FOA.
Question: Will the grant fund the implementation of EHRs in community health centers or are you assuming that EHRs are already in place?
Answer: Can you use money from this grant to fund EHR implementation? Technically, absolutely, yes, that is an allowable expense. However, your application will be reviewed based on the review criteria, which are about the measurement and your outcomes. This is not an implementation-focused grant.
Additional staff members wanted to me to point out that the FOA clearly states that one of the criteria you'll be evaluated on is the sustainability of your projects. So if you are planning to use funding or if you proposed to use funding to implement an EHR and can't show that it would be sustainable without this grant funding, that would not be in keeping with the requirement of the grants and would not be reviewed favorably by a review committee.
In short, yes, you may use funds for implementation, but that is not the focus of this FOA.
Question: Would consortia of ambulatory care organizations as opposed to single organizations be given preference?
Answer: Consortia are encouraged. There still needs to be an institution which meets the federal requirements to receive federal funds, that is the lead organization. It could be a consortium, but often it's one of the members of the consortia. There is no special preference, however, for the consortia per se. However, we do indicate that there are other things that consortia can do, such as bringing an interdisciplinary team together or testing measures in multiple settings, both of which are explicit review criteria.
For a clarification on that, just remember what we talked about earlier about what the eligible applicant has to be. The eligible applicant is the lead consortia member. Please direct any additional questions related to that specific topic to Al Deal.
Question: My question is regarding the timeline. Since the grant lasts for 24 months, if you have a year to implement EHR, and then following that you would have to show your results, in what kind of time period are you expected to show results of quality measurement?
Answer: We told you when to start your budgeting process, but there was a question about when you're going to be doing measurement activities. If you need to implement and then measure, you should discuss in your application about when data will be available. For this, we refer you back to the FOA: What are your specific aims? How are you meeting the goals? What are the specific outcomes that you are proposing? Then at the end of 24 months, you must be able to demonstrate that you've met those aims or that you're able to give data to answer your outcomes; so what you've set out for yourself, how you divide it up, what part is implementation versus what part is measurement, is up to your discretion. But you will be evaluated on whether the methods that you propose are feasible, as described in the review criteria the committee will use.
Question: If we apply for the special set aside that doesn't involve Health IT, do we need an evaluation component with patients and therefore need to do an IRB?
Answer: Regarding the need for IRB reviews, specifically in the context of people who are not using Health IT, all applications will be reviewed, with specific review criteria regarding your human subjects protection planning. All applications will need to meet Federal requirements to address Protections of Human Subjects and have that plan specified in the application. That plan will be reviewed and assessed by the peer review group.
However, you do not need to have your IRB approval when you submit your application. If your application is selected for funding, you will need to provide IRB approval prior to issuance of the grant award. And if you have additional questions about that, there are some citations in the FOA or you can contact us about that process.
Question: If we are developing a new measure—a new quality measure but applying for the non-IT portion of the grant, does that measure have to be taken from electronic data or can it be from clinical data?
Answer: The next question had to do with folks who are choosing to develop new quality measures and looking to do that in the realm outside of Health IT. They are therefore requesting special funding preference and for projects that then use clinical data. Those that say they want to be considered in Appendix A under the special funding preference of non-Health IT quality measure development are not required to meet the Health IT-specific requirements in the FOA.
Question: Yes. Is the indirect costs rate the institution's federally approved indirect cost rate or a separate flat fixed rate?
Answer: No, this is a federal grant opportunity and the institution, if it has one, uses its own predetermined negotiated rate.
Question: Does the applicant organization need to be an ambulatory care provider?
Answer: No. They do need to meet the requirements of a lead organization, such as, they must be a public or government or Native American organization. However, if a non-ambulatory lead organization applies, it is expected that they will act in partnership with an ambulatory setting or group that is a partner in this application. But the lead can be either the ambulatory or the non-ambulatory organization, as long as they meet the other requirements.
Question: If no IT measures exist presently those that were mentioned several times earlier are the ones that may be used. By "mentioned earlier," I mean that in reading over the grant opportunity materials, on several occasions a site would mention where one could go to look for existing electronic measures.
Answer: If there is no Health IT measurement in existence, is it okay to use a new measure. This brings up several different possible answers that everyone should hear.
The first is for measurement. The application has two different buckets. Some people may want to measure the use of Health IT or the processes of using Health IT to measure quality. So their focus is on harnessing the Health IT tool. For those, it is encouraged, but not required, that the measures for clinical quality are the AQA, AHRQ developed or HQA measure sets.
Our second bucket of applications, we expect, are people who are not looking at the process of Health IT, but the measurement itself of clinical quality and ambulatory safety and care. Those folks, if there's no measure in existence, of course they're encouraged to develop new measures. At other times they may be looking at new settings, in which case, they are, again, encouraged to use the starter measures have already been proposed.
A third group to think about in measuring the project: AHRQ has required that, where applicable, you look at five specific measurements. And if your project touches on them, we expect that you will show us in your application how you will measure and collect that information.
If you are not doing a Health IT project and therefore are not in the Health IT sphere, you would say these are not applicable to your application.
That was a complicated question with a complicated answer. Feel free to write to email@example.com if you need further clarification.
Question: Can the funds be used to lease an EHR system and should the budget start from July 1?
Answer: Leasing of an EHR is an acceptable, budgetable expense and can be included in your budget. We recommend that you don't propose a budget that begins before July 1, 2007, because that's the earliest anticipated start date. As these are FY 2007 grants, we expect that all programs will have a budget that starts sometime during the fiscal year 2007, which means before October 1, 2007. So it is up to you. You do not need to start on July 1. You propose when your project will start.
Question: I have a question about the transitions. Would transition provisions between providers within the same setting (ambulatory care) be considered a transition, for example, at a clinic with a staff of rotating physicians?
Answer: Yes, as long as you are in the ambulatory care setting.
Question: The FOA lists nine priority areas for national action; however, the actual IOM report has about 20 areas, including major depression, screening and treatment, and severe and persistent mental illness. I was wondering whether an application submitted under these additional areas would be considered?
Answer: Regarding IOM priority areas, the caller is absolutely correct. The IOM has a much larger list. We provided nine as examples. Any other IOM priority condition is also encouraged for study.
Question: I was wondering where it says that the use of certified products is highly encouraged. If our system that we're putting in does not use a product on that list, how much of a deterrent is that going to be?
Answer: The FOA encourages the use of these products, but it is not a requirement for application.
Responses to Presubmitted Questions
Question: What type of staffing and research capabilities do you expect applicants to propose. We have discussed the PI being an implementation person, is that okay?
Answer: Please refer to the FOA. We understand that the project's PI may not have the expertise in all of the areas that your project touches on. And it is acceptable that if that person is the facilitator and lead and has one area of expertise, then, you would demonstrate how the rest of the team brings the other skills. That's encouraged and expected. As the FOA states, we expect the project team to be appropriate to conduct the proposed work.
Question: Is there some proportion of the budget that can be used for purchasing applications versus staffing?, and specifically, therefore, hardware and technology.
The FOA does allow for the purchase of hardware or, as we said, the leasing of software and/or the leasing of technology. It is important for everybody applying to remember that one of the criteria you will be reviewed on is the reasonableness of your budget. The reviewers will look at your proposed budget and say, Is the proportion that you have submitted that is going for staff versus research and people appropriate? And the peer reviewers will make that determination.
Question: Out of the two programs, Enabling Quality Measurement Through Health IT, which we're discussing now, and Improving Quality Through Clinician Use of Health IT, does one program have a greater academic or research focus than the other?
Answer: No. These are both R18 mechanisms. However, let me point out, these are both research mechanisms and are not designed, as the criteria described, to be simple implementation projects.
Question: What characteristics or qualifications is AHRQ looking for in the principal investigator?
Answer: For our answer to that, we will bring you back to our slides and to the FOA itself for the criteria of what we expect in the PI. Again, I will point out that the PI is expected to spend a significant portion of his or her time, and, if it is less than 20 percent, that needs to be justified. We expect it to be a senior person with expertise. But that person does not necessarily have to have all of the expertise necessary; they can count on the members of their teams.
The next question referred to looking at the FOA and what was spelled out to be in the different sections of the SF 424 R&R, versus the instructions one gets from the SF 424 R&R. Specifically, the FOA doesn't mention the preliminary study.
The FOA is your guiding principle. Anything that is stated here is required. Things not mentioned in the FOA that are then described and asked for in the SF 424 should be placed in their correct location.
If at any time you believe there is a conflict of information, you are free to contact AHRQ staff to clarify. But in general, our answer is that the FOA trumps the SF 424, but we have worked hard to make sure that there are not any contradictions.
Question: What percent of funded projects will be for EHR or PHR interventions, or what percent of funded projects will be other IT interventions?
Answer: There is no specific percentage in the FOA. On a related but not exactly the same question, we plan to have a funding preference for $1.8 million for the non-Health IT.
Question: Are there any limitations with working with the Department of Veterans Affairs (VA) as an ambulatory partner?
Answer: This is a very good question with a difficult answer. Federal funds cannot be used to pay the salaries of the VA employees. That means they cannot be included in the budget. However, if your research is to be conducted in the setting of an ambulatory VA center, it would be acceptable that the VA is your partner.
Specifically, we strongly recommend that anyone working with a VA partner work closely with the VA medical center, not just the investigator. Individuals who work for the VA who you'd like to involve may have the ability to be a consultant in their time outside of their VA employment. Again, you'll have to talk with that person and their VA employer.
Question: Do we have to have an ambulatory center as a partner if we are working with the analysis of quality measures across many organizations?
Answer: Yes. The ambulatory partner may be the lead or may be a partner, but an ambulatory care provider must be included in your application.
The next question had to do with the fact that while this is an Health IT-focused solicitation, there is a part of it in measurement that is non-Health IT-focused, and that's the special funding. And for those who applied for it under Appendix A, they are not required to meet the Health IT requirements of the FOA.
There is an additional FOA that also has a non-Health IT component, and that is the risk assessment in ambulatory care FOA. People who are interested in these two are eligible to apply under one or the other or both. There will be a technical assistance call for those interested in the Risk Assessment in Ambulatory Care FOA.
Question: The final question on our list today was whether you could develop a new quality measure and test it across transitions from ambulatory to hospital, to nursing home.
Answer: That would generally be acceptable in the ambulatory care to hospital setting. In general, just looking at hospital to nursing home transition would be considered a non-ambulatory transition to a non-ambulatory setting, and that would not be the main focus of this FOA. However, the focus on ambulatory quality, developing new quality measures for transitions from ambulatory to in-patient or in-patient to ambulatory, is the focus.
You know, as a final point and thinking about the question we answered a moment ago, we recommend that those who are interested in this FOA consider looking at the notes of the technical assistance calls from other FOAs because it is possible somebody will bring up a clarifying question that will clarify this FOA in the context of the other calls. All of them will be available on the AHRQ Web site after the call.
Thank you all for your patience. And one final word of advice that was passed along from the staff is that everyone should pay special attention to the other review criteria, which include:
Your application should make it easy for the reviewers to understand how you are addressing those three requirements.
With that last bit of advice, we thank you all for joining us. We will be back at 1:30 for our second technical assistance call. And for those interested in the transcripts, we will be posting these at a later date on the Web site. And I believe we'll attempt to email those of you who registered for the conference call at your E-mail address when it is available.
Thank you so much.
Current as of February 2007
The information on this page is archived and provided for reference purposes only.