22VAC30-50 Policies and Procedures for Administering the Commonwealth Neurotrauma Initiative Trust Fund

REGULATIONS

Vol. 32 Iss. 7 - November 30, 2015

TITLE 22. SOCIAL SERVICES

DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES

Chapter 50

Proposed Regulation

Title of Regulation: 22VAC30-50. Policies and Procedures for Administering the Commonwealth Neurotrauma Initiative Trust Fund (amending 22VAC30-50-10, 22VAC30-50-20, 22VAC30-50-30, 22VAC30-50-50 through 22VAC30-50-120).

Statutory Authority: §§ 51.5-131 and 51.5-181 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: January 29, 2016.

Agency Contact: Vanessa S. Rakestraw, Ph.D., CRC, Policy Analyst, Department for Aging and Rehabilitative Services, 8004 Franklin Farms Drive, Richmond, VA 23229, telephone [phone], FAX [phone], TTY [phone], or email [e-mail].

Basis: Section 51.5-181 of the Code of Virginia states (i) "The Commissioner shall promulgate regulations establishing procedures and policies for soliciting and receiving grant applications and criteria for reviewing and ranking such applications, including, but not limited to, goals, timelines, forms, eligibility, and mechanisms to ensure avoidance of any conflicts of interest or appearances thereof" and (ii) "The Commissioner shall receive the recommendations of the Commonwealth Neurotrauma Initiative Advisory Board prior to promulgating or revising any such regulations."

Purpose: The purpose of the proposed amendment to the Commonwealth Neurotrauma Initiative (CNI) trust fund regulation is to conserve moneys in the fund and distribute the moneys equitably for their intended purpose. The proposed amendment emphasizes that requests for applications for moneys from the fund shall be issued by the advisory board only when the board determines that funds are available. The proposed amendment allows grantees to use the fund for evaluating existing programs as well as expanding, developing, and improving programs. This proposed amendment emphasizes original Code of Virginia language that grant funds are to be used for initiating research projects or community-based rehabilitative programs. They are not to be used for long-term funding of projects. To ensure that applicants understand and plan for this, applications must contain a plan for sustaining the project upon termination of grant funds. In an effort to conserve funds, applicants are required to demonstrate that the proposed project does not duplicate existing programs. In the event of a decline in moneys in the fund, the board shall attempt to distribute moneys in a manner as fair and equitable as possible. These regulations are necessary to administer the CNI Trust Fund, which protects the public health, safety, and welfare by providing funding for research and improving the treatment and care of neurotrauma.

Substance: The changes provide clarification to the existing regulation in the following ways: (i) a statement is added that requests for applications for grant moneys from the CNI Trust Fund shall be issued at the discretion of the advisory board and shall depend upon the availability of funds to clarify the conditions under which requests for applications will be made and inform the public that requests are not made on a regularly scheduled basis; (ii) a statement that applicants can now apply for grants to evaluate systems of services for people with traumatic brain injuries or traumatic spinal cord injuries is added, which allows applicants to apply for funding to conduct targeted evaluations of service systems or to determine the need for the development, expansion, or improvement of services; (iii) text is reworded to stress to applicants that grants are to be used to initiate research and programs but not to be used to maintain long-term funding; this is also emphasized by the addition of a statement that the advisory board shall accept applications that provide a plan for sustaining the proposed project following termination of a grant award, and that applicants for grant funds must (a) include a description of efforts taken to ensure that the proposed project does not duplicate existing programs or services for persons with neurotrauma already available in the community and (b) demonstrate a commitment to community planning with consumer groups, service providers, employers, relevant state and local agencies, and other funding sources which may be available; and (iv) in the event of a decline in moneys in the CNI Trust Fund, the advisory board shall attempt to distribute moneys in a manner that is fair and equitable as possible to all projects, which in the past, only applied to projects with an anticipated duration greater than one year.

Issues: The proposed regulatory action poses no disadvantages to the public or the Commonwealth. The action's primary advantage is that it clarifies the existing regulation.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The proposed changes will 1) require the Commonwealth Neurotrauma Initiative Trust Fund Advisory Board to distribute moneys in a manner that is as fair and equitable as possible to all projects in the event of a decline in moneys in the fund and 2) clarify existing language, policy, and procedures followed in practice.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. These regulations establish policies and procedures for administering the Commonwealth Neurotrauma Initiative Trust Fund (the fund). The purpose of the fund is to promote medical research into traumatic brain and spinal cord injuries and to improve treatment and care through the provision of community-based services for individuals who have sustained such injuries. Although the fund accepts grants, donations, and bequests from public or private sources, the main source of revenue is the $25 reinstatement fee collected by the Department of Motor Vehicles to restore the driving privileges of a person whose license has been revoked or suspended for specific driving offenses (e.g., DUI-related offenses, hit-and-run, reckless driving, habitual offender, etc.). In the last three years, the revenues were about $1 million per year. ¹

Once the fund accumulates enough revenues, the fund's Advisory Board disburses moneys through a grant application process for research studies and community-based rehabilitation services. The fund issued 7 grants totaling $1.6 million in 2012, 5 grants totaling $931,000 in 2013, and 2 grants totaling $214,657 in 2014.² All of the grant recipients were affiliated with medical colleges in Virginia.

One of the proposed changes will require the Advisory Board to distribute moneys in a manner that is as fair and equitable as possible to all projects in the event of a decline in moneys in the fund. Currently, the regulation requires that long-term projects be funded first in the event of a decline in the moneys. The proposed change will allow distribution of moneys when there is a decline in the fund, among all projects regardless of their duration. Thus, short-term projects will not lose all funding when the moneys in the fund decline. This proposed change is not likely to have an economic impact in the foreseeable future since the fund currently has a healthy balance.

The remaining proposed changes are clarifications of existing language, policy, and procedures followed in practice and are not anticipated to have any significant economic impact other than improving the clarity of the regulations.

Businesses and Entities Affected. The proposed amendments will affect grant recipients when and if the moneys in the fund decline. The fund issued 7 grants in 2012, 5 grants in 2013, and 2 grants in 2014. Currently, there are only two active grants.

Localities Particularly Affected. The regulations apply throughout the Commonwealth.

Projected Impact on Employment. The proposed amendments are unlikely to significantly affect employment.

Effects on the Use and Value of Private Property. The proposed amendments will not affect the use and value of private property.

Small Businesses: Costs and Other Effects. The proposed amendments will not affect small businesses.

Small Businesses: Alternative Method that Minimizes Adverse Impact. The proposed amendments will not have an adverse impact on small businesses.

Real Estate Development Costs. The proposed amendments will not affect real estate development costs.

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¹ Source: The fund's triennial report for fiscal years 2012, 2013, and 2014 to the Governor and the General Assembly.

² Ibid

Agency's Response to Economic Impact Analysis: The Department for Aging and Rehabilitative Services agrees that the information provided by the Department of Planning and Budget (DPB) in the February 3, 2015, economic impact analysis of the proposed amendments to 22VAC30-50, Policies and Procedures for Administering the Commonwealth Neurotrauma Initiative Trust Fund, was correct at the time of completion. There is a statement in the DPB analysis that all grant recipients were affiliated with medical colleges in Virginia. This is now inaccurate as some grants have gone to programs that are not affiliated with medical colleges in Virginia. However, this should not have a substantial impact on the economic impact analysis

Summary:

The proposed amendments (i) clarify that requests for proposals shall be issued at the discretion of the Commonwealth Neurotrauma Initiative Advisory Board and shall depend upon the availability of funds; (ii) emphasize that grants provided by the fund are not to be used for long-term funding of research or community based rehabilitative programs; (iii) require that applicants for grants under this fund provide a plan for sustaining the proposed project following the termination of the grant award; and (iv) make technical corrections, update statutory references, and make other necessary changes.

Part I
Definitions and General Information

22VAC30-50-10. Definitions.

The following words and terms when used in this chapter shall have the following meaning meanings unless the context clearly indicates otherwise:

"Advisory board" means the Commonwealth Neurotrauma Initiative Advisory Board.

"Commissioner" means the Commissioner of the Department for Aging and Rehabilitative Services.

"Department" means the Department for Aging and Rehabilitative Services.

"Fund" means the Commonwealth Neurotrauma Initiative Trust Fund.

"Neurotrauma" means an injury to the central nervous system, i.e. (i.e., a traumatic spinal cord or brain injury, which injury) that results in loss of physical functions, cognitive functions, or both.

"RFP" or "request" means a request for proposals issued by the advisory board seeking applications for grant moneys in the fund.

22VAC30-50-20. Statement of general policy.

The Commonwealth of Virginia has recognized the need to prevent traumatic spinal cord and brain injuries and is committed to improving the treatment and care of Virginians with traumatic spinal cord and brain injuries. By creating the fund and authorizing the advisory board to administer the fund, the Commonwealth of Virginia makes grant funds available to Virginia-based organizations, institutions, and researchers to address these needs. The advisory board administers the fund to carry out the intent of the law in accordance with its authority.

22VAC30-50-30. Disbursement of funds.

A. This chapter serves to (i) establish policies and procedures for soliciting and receiving applications for grants from the fund, (ii) establish criteria for reviewing and ranking such applications, and (iii) establish procedures for distributing moneys in the fund, which shall be used solely to provide grants to Virginia-based organizations, institutions, and researchers.

B. Forty-seven and one-half percent of the moneys in the fund distributed under this chapter shall be allocated for research on the mechanisms and treatment of neurotrauma; 47-1/2% of the moneys shall be allocated for rehabilitative services, i.e. (i.e., the development of innovative, model community-based rehabilitative programs and services for individuals with neurotrauma); and 5.0% of the moneys shall be allocated for the Department for Aging and Rehabilitative Services' department's costs for administering and staffing the Commonwealth Neurotrauma Initiative Trust Fund fund and advisory board.

22VAC30-50-50. Application of exemption to the Virginia Freedom of Information Act.

Pursuant to a provision subdivision 12 of § 2.2-3705.5 of the Virginia Freedom of Information Act, Chapter 37 (§ 2.2-3700 et seq.) of Title 2.2 of the Code of Virginia, records submitted to the advisory board as a grant application, or accompanying a grant application, pursuant to the law Chapter 14 (§ 51.5-178 et seq.) of Title 51.5 of the Code of Virginia and this chapter are excluded from the requirement of open inspection to the extent that they contain medical or mental health records or other data identifying individual patients, or proprietary business or research-related information produced or collected by an applicant in the conduct of or as a result of study or research on medical, rehabilitative, scientific, technical, or scholarly issues. This exemption shall apply when such the information has not been publicly released, published, copyrighted, or patented, if the disclosure of such the information would be harmful to the competitive position of the applicant. The advisory board intends to rely upon this exemption in order to encourage the submission of applications.

Part II
Soliciting and Reviewing Applications

22VAC30-50-60. Requests for proposals.

The advisory board will shall solicit applications for grants of moneys from the fund by issuing requests for proposals RFPs from time to time. These RFPs shall be issued at the discretion of the advisory board and shall depend upon the availability of moneys in the fund. Each application for a grant must be received submitted in response to an actual request for a proposal RFP and received by a deadline specified in the request RFP.

22VAC30-50-70. Grant reviewers and technical advisors.

The advisory board may choose, at any time, to appoint grant reviewers or other technical advisors, or both, to assist in reviewing and ranking applications. Such reviewers and advisors may represent medical researchers, medical practitioners, community-based service providers, consumers, advocates for consumers, or others deemed appropriate by the advisory board for this purpose. Reviewers and advisors shall be appointed so as to provide equal representation from Virginia's three medical schools. Reviewers and advisors shall be selected so as to avoid any conflict of interests or the appearance thereof, and the advisory board may choose reviewers and advisors residing or working outside Virginia to ensure impartiality. Whenever reviewers or advisors sit as a committee, the chairman chair of the advisory board or his designee shall serve as chairman chair of the committee but shall not vote on individual applications.

22VAC30-50-80. Specification of Option A or B.

Each application shall clearly state a purpose to seek funds for projects to conduct research on the mechanisms and treatment of neurotrauma, which shall be referred to as "Option A," or to develop innovative, model community-based rehabilitative programs and services for individuals with neurotrauma, which shall be referred to as "Option B." Option A applications shall state and demonstrate a clear intention of researching the mechanisms of neurotrauma or the treatment of neurotrauma, or both. Option B applications shall state and demonstrate a clear intention to provide innovative, model community-based rehabilitative services by developing, expanding, evaluating, or improving community-based programs and services for people with traumatic brain injury or traumatic spinal cord injury, or both, and expanding opportunities for such these individuals to become as independent and physically and functionally capable as possible. Neither Option A nor Option B grants are intended shall be used for long-term funding of research projects or service community-based rehabilitative programs and services.

22VAC30-50-90. Submission of applications.

In reviewing applications submitted for grant awards, whether Option A or Option B, the advisory board will shall accept applications that:

1. Present a clear and convincing and persuasive discussion of how the proposed project will shall carry out its intention as specified in accordance with 22VAC30-50-80, and describe in as much detail as possible its anticipated effectiveness in carrying out its intention;

2. Comply fully with informational and administrative requirements stated in the specific RFP to which applicants are responding; and

3. In the case of an Option A application:

a. Discuss the relevance of the proposed project to an identified field of medical or rehabilitative inquiry;

b. Demonstrate the anticipated benefit of the proposed project in terms of expanding knowledge and understanding of neurotrauma;

c. Discuss any innovation or breakthrough the project seeks to promote, specifying outcome measures where possible for each of the preceding enumerated items in this subdivision; and

d. Describe efforts to ensure that the proposed project does not duplicate previous or ongoing research; or and

e. Provide a plan for sustaining the proposed project following termination of a grant award as relevant to the intention of the proposed project; or

4. In the case of an Option B application:

a. Discuss the relevance of the proposed project to an identified need for innovative, model community-based rehabilitative programs and services in terms of the absence of alternative programs, services, and resources available to the intended individuals and community;

b. Describe efforts to ensure that the proposed project does not duplicate existing programs, services, or resources already available to targeted individuals and communities; and

c. State and emphasize Demonstrate a commitment to collaborative community planning involving consumer groups, service providers, employers, relevant state and local agencies, and other funding sources, as available or anticipated to become available. and appropriate; and

d. Provide a plan for sustaining the proposed project following termination of a grant award as relevant to the intention of the proposed project.

Part III
Specific Project Consideration and Application Criteria, Selection of Successful Applications and Amount and Announcement of Awards

22VAC30-50-100. Reviewing and ranking grant applications.

A. The advisory board will shall distinguish the class of Option A applications from the class of Option B applications when soliciting, reviewing, and ranking grant applications. Applications will shall be considered and ranked only among other applications submitted under the same stated option, either Option A or Option B. Applications initially deemed effective in meeting to meet the purpose of a solicitation and to have substantially addressed the general considerations stated in Part II (22VAC30-50-60 et seq.) of this chapter 22VAC30-50-60 through 22VAC30-50-90, as applicable, will shall be subsequently reviewed and ranked according to the following criteria:

1. The purpose and significance of the project;

2. The objectives and expected benefits of the project;

3. The design of the project to include (i) methods, activities, and a timeline for achieving project goals and objectives, and (ii) a system for measuring outcomes and documenting project impact, effectiveness, and any anticipated long-term effects;

4. A detailed budget that is reasonable and appropriate for the scope of the project;

5. The identification of potential sources of funds and fundraising strategies to be used in sustaining the proposed project following termination of a grant award as relevant to the intention of the proposed project;

6. Demonstrated or anticipated capability of the existing or planned organizational structure;

7. The means for consumer involvement in the design, implementation, and evaluation of the project as feasible and relevant to the intention of the proposed project; and

8. A commitment to include the participation of small, women-owned and minority businesses, as such are available and capable of participation.

B. When initially reviewing applications or subsequently reviewing and ranking applications, the advisory board may ask applicants an applicant to provide required information that is missing from the application or additional clarifying information relating to their applications the application and proposed projects project. Failure to provide missing information or failure to provide additional information that is material and relevant may result in the rejection or lowered ranking of an application.

22VAC30-50-110. Amount of grant awards; duration and availability of funding.

A. After reviewing all applications, duly received accepted, for either Option A or Option B, the advisory board will shall determine which the proposed projects will that shall be offered funding. The selection of successful applications will shall be made based on (i) availability of moneys in the fund, (ii) the review and ranking of the applications according to the criteria listed in this chapter 22VAC30-50-100 A, (iii) information from grant reviewers or technical advisors who appointed by the board may appoint to assist in evaluating applications, and (iv) the advisory board's assessment of those the applications, as to which further the intentions and the purpose of the fund. Discussions and negotiations may be conducted between the advisory board and grant applicants in order to clarify any remaining issues relating to the proposed project.

B. In considering and determining the amount of a grant award and the duration of funding for a particular project, the advisory board will shall consider the requested amount, the project design, and justification. Actual grant Grant awards will be made in amounts ranging shall range in amount from $5,000 to $150,000 per year for an anticipated funding period of one to three years as described in the proposal RFP. The award and duration of funding of a project anticipated to exceed one year will shall be contingent upon (i) the availability of moneys in the fund, whether so stated at the time of the award or not, and (ii) the grantee's successful completion of timelines and of interim objectives and milestones as proposed and approved in the grant application, grant award, and contract documents.

C. In the event any timelines and interim objectives and milestones pertaining to a project are not completed to the satisfaction of the advisory board, the advisory board may act to withhold moneys not yet disbursed for such a the project. In the event of a substantial decline in moneys in the fund, the advisory board will shall attempt to distribute moneys to projects of an anticipated duration greater than one year in a manner as fair and equitable as possible.

D. The award of grants to successful applicants will shall be made public within 60 days of the advisory board's decision regarding all applications submitted in response to a request for proposals an RFP.

22VAC30-50-120. Unexpended funds.

Notwithstanding any other law to the contrary, the Commissioner of the Department for Aging and Rehabilitative Services commissioner may reallocate up to $500,000 from unexpended balances in the Commonwealth Neurotrauma Initiative Trust Fund to fund for new grant awards for research on traumatic brain and spinal cord injuries.

VA.R. Doc. No. R14-3419; Filed November 5, 2015, 4:16 p.m.