Duke Medicine is committed to working with the people of Durham County to improve the health of all residents in the County.

In addition to providing traditional health care through clinics, hospital-based care and home health, Duke is making resources available, through this RFP, to Duke-Durham partnerships to develop plans for innovative models of care and/or services that will improve health in Durham County.

Funds to support this RFP come from the Clinical and Translational Sciences Award (funded by the National Institutes of Health) and from Duke University. This RFP is specifically oriented to the special mission of Duke in its home community of Durham County.

Requirements

• ensure active involvement of Duke and Durham team members in program planning, implementation, evaluation, and dissemination;
• identify a cause of death and/or disability of significance in Durham County;
• identify causal factors of the problem (biological, behavioral, social and/or environmental);
• identify a target population of residents who are affected by the problem or are at risk;
• include input from and the involvement of members of the targeted population;
• develop a business plan for an alternative model of care/prevention to lower morbidity and mortality;
• participate in monthly meetings: to review program expectations and progress; to share experiences with other projects, and to engage in collaborative problem solving in business plan development.

Total Awards: Each award to develop a plan will be up to $100,000 for 8 months. 10 awards are anticipated.

Application Process

See Required Elements

Technical Assistance Workshops for Duke-Durham team members are required for both stages of the application process.

Key Dates and Deadlines

• August 15, 2008, September 2, 2008, and October 10, 2008 – Stage 1 Brief Proposal Required Technical Assistance Workshops
  
• November 7, 2008 – Deadline for Stage 1 Brief Proposals
  
• December 15, 2008 – Duke-Durham Teams notified if they are invited to submit Stage 2 Full Proposals
  
• January, 2009 – Required Technical Assistance Workshop for Duke-Durham Teams invited to submit Full Proposals
  
• March 2, 2009 – Deadline for Receipt of Invited Stage 2 Full Proposals
  
• April 3, 2009 – Awards made to selected Duke-Durham Teams to develop full plans
  
• December 4, 2009 – Full plans due

Presentations:

Links:

Resources:

How to Apply

Stage 1 Brief Proposal

Stage 1 Brief Proposals are limited to three (3) single-sided pages, single-spaced, 12 point font, one-inch margins. The Brief Proposal must include the following:

1. A description of the need to be addressed, how the need was determined, and the population affected.
2. A description of all of the team members and their experience in working with the health issue/population served.
3. A preliminary description of the potential change, and benefits to the population(s) served that would be addressed in the team’s plan.
4. A preliminary estimate of the total funds needed to create a plan. The estimate should delineate the roles and responsibilities of the team members/partner organizations with respect to resources, in-kind and direct. Applicants are encouraged to seek matching funds from the University and Duke Medicine and/or from relevant government or community agencies.

Required Attachments

• A cover page indicating:
  • project title
  • team name
  • team contact (must be a Duke faculty member)- name, title, campus office address, email, and phone
  • team members and their organizational information – name, title, mailing address, email, and phone
• A project abstract on the cover page not to exceed 100 words.

Submission Instructions

Please send the Brief Proposal and the required attachments via e-mail to: DukeDurhamTeams@mc.duke.edu

Stage 1: Technical Assistance

Required technical assistance workshop for Stage 1 Brief Proposal Development weree held in August, September, and October.

At least one member from each Duke-Durham team had to attend a technical assistance workshop in order to submit a Brief Proposal.

Stage 2: Invited Full Proposals

By December 15, 2008 selected Stage 1 Duke-Durham Teams will be invited to submit full proposals. Duke-Durham Teams invited to submit full proposals will be required to attend a technical assistance workshop and will be provided with specific contacts for utilizing required institutional resources as described in the Required Elements Section.

Required Elements

Clear Identification of a Relevant Health Issue and Population

In most cases, relevant conditions are diseases (e.g., cancer, stroke, diabetes), although conditions (e.g., obesity, pregnancy, frailty, blindness) are eligible, as are specific behaviors (e.g., smoking, violence). Teams must clearly identify how the need was determined. While all ages are eligible for consideration, the team must clearly identify the population affected. Preference will be given to the more common causes of death and disability and to situations in which results can be achieved in a 5 year period. “Bundling” is also encouraged where common interventions can be used together (e.g. it would be preferable to have a “vascular disease” primary and secondary prevention intervention rather than separate interventions for hypertension, exercise, smoking, lipids, etc.).

An Interdisciplinary Duke-Durham Team

Teams must be interdisciplinary and include expertise in areas appropriate to the proposal from across Duke University and Medical Center (at a minimum a Duke physician, nurse, and Health System administrator) and must include appropriate residents and partners from the Durham Community, who are not Duke employees, as part of the core team. Teams are encouraged to include Duke trainees where they can contribute to the process.

Description of an Alternative Model of Care

It is anticipated that Duke-Durham Teams will propose plans that will describe a significant change in the structure or function of a service or clinic, including such alternative models as: clinics and clinical services run by midlevel providers; use of lay or community health workers; services or systems that effectively combine the services of public or non-profit agencies and Duke Medicine services; services that are provided in non-health care settings (such as local businesses, houses of worship, schools, or public facilities), use of new technologies (including information systems) that reduce cost, increase efficiency or provide health and disease monitoring.

Use of Institutional Resources: Electronic Health Record (EHR), Data Support Repository (DSR), Geospatial/Temporal Mapping, and Biostatistical Support

While any public or private source of data may be used, the Duke-Durham Teams are required to use the Data Support Repository as a key source in Stage 2 proposal development and selected grantees will be expected to use the DSR in their proposal development. In some cases this may require working with Health System entities to contribute existing data to the DSR. Duke-Durham Teams will also be expected to utilize geospatial/temporal mapping from the DSR and enable ongoing mapping of the disease/condition and outcomes using the system. Formal biostatistical support is required and should be included in the budget proposal for teams that advance to Stage 2 proposal development. Key Contacts for these institutional resources will be available at the technical assistance workshops and will provide technical assistance during Stage 1 and 2 proposal development.

Financial Model

Duke is committed to caring for the people of Durham County that reflects community priorities. At the same time, Duke has a responsibility to maintain financial solvency to carry on its missions in patient care, research, and teaching. Duke-Durham Teams will include a number of factors in developing models for the financial efficacy of their plans. Such factors may include reducing the utilization of high-cost services (such as the use of emergency departments for non-emergent conditions), and reducing admissions to limited subspecialty hospital beds which can be freed up for “high tech” interventions that need to be accessible on a broader geographical base.

Evaluation Plan

The proposal must describe an evaluation plan that establishes measurable markers to determine the efficacy of the proposed activities/service.

Dissemination Requirements

The proposal must also describe how the project team intends to maintain communication with the community and inform members of the community or population served of its findings, and future steps. In addition, Duke-Durham teams will be required to submit at least one manuscript to an appropriate peer-reviewed journal.