Program Eligibility & Requirements
    Application Process
    Leadership Training
    Program Structure

Program Eligibility & Requirements

1) Is there any flexibility in the requirement that applicants be Nurses, Physicians, or Social Workers?
The mission of the program's funder, the Atlantic Philanthropies, includes reaching out to only these three disciplines. Therefore, at this time, the program is only accepting applications from individuals who meet this requirement.

2) Can an individual working overseas who is not a USA national apply to the fellowship?
No, the program is only open to individuals living and practicing in the United States.

3) Should applicants be early, mid, or late career?
Given the heterogeneity in career paths across the three disciplines, the NPO does not wish to be overly proscriptive. It is anticipated that applicants were all initially trained as clinicians but now have taken on positions with operational influence. The NPO also recognizes that some individuals may have been relatively "senior" in a prior position, but are relatively new to the field of aging. In any case, applicants should have some experience creating or managing aging-related programs. Finally, the selection committee will look at the applicants' influence as well as their career trajectories, which should be detailed in the applicant's 5-year goals.

4) Is it a disadvantage if an applicant is employed within the same organization as one of the National Advisory Board members?
An applicant can be from the same organization as an Advisory Board member.

5) The application states that prospective Fellows should have the capacity to influence care on a national scale. What if the applicant's home institution does not have a national reach?
The goal of the program is to form a national cohesion of like-minded individuals committed to helping improve care to older adults. Applicants may wish to emphasize how their proposed project accomplishments could reach other populations of older adults that are affiliated with their home institution, or a national professional society or other national network.

6) The application uses the terms "health organization" and "health care organization" as part of the eligibility requirements description. Does this include long term care?
The program embraces a very broad definition of "health" that encompasses promotion, prevention, direct care, or partnering with an agency that provides any of these. The PCF tri-annual meetings will attempt to reflect this breadth. However, some of the skills workshops and discussions around financing will emphasize the traditional health care delivery system. Individuals who function in this environment or at the interface between a community organization and health care delivery will likely stand to benefit more from the program.

7) Does "health care delivery organization" include both physical and mental health?
Yes. Applicants should provide details in their application of what particular populations and what particular care needs will be the focus for the project. The program has a broad view of health and emphasizes a strong attention to measurement of patient-centered outcomes.

8) What are the applicant's home institution's commitment requirements regarding funding?
Applicants should show that their home institution is engaged and committed to supporting the applicant's participation in the program. However, the cost-sharing requirement is viewed very broadly as the program understands that each applicant and home institution faces unique challenges in meeting this requirement. Examples of cost-sharing can include: making up the difference of the Fellow's salary and benefits that are not supported by program PCF funds, providing access to formal leadership training programs, and/or supporting the time contributed by the Fellow's supervisor and/or his or her attendance at one of the tri-annual meetings per year. The cash value of in-kind contributions should be estimated, and contributions should total $45,000 over the 2 year period.

9) Does the applicant's home institution need to be a non-profit organization?
No. The only requirement is that the home institution serves older adults in a health or health care capacity.

10) Does the Fellow need to be employed full time by their home institution?
That is flexible, but should be fully detailed in the application. The 20% time commitment will always be based on a 1.0 full-time equivalent position. Applicants who are not employed full time by their home institution should provide details in their application regarding the scope of their influence and leverage within their respective organizations, and letters of support should be obtained from leaders of the two participating institutions.

11) Is obtaining additional external funding beyond my home institution required?
Obtaining external funding is not required.

12) If an applicant is employed by, or is affiliated with, more than one institution, how would the home institution be determined?
The home institution is whichever organization is willing to support the Fellow's participation in the program, including providing the required cost share contribution.

13) Is it acceptable if the candidate's home institution is an agency that does not provide direct care services?
Yes. While some community organizations do not provide care directly, they can have influence over the way care is provided and would be appropriate, provided this point is developed in the application.

Application Process

1) The application asks applicants to articulate their 5 year career goals. Please clarify this request.
The purpose of this question is to provide the Selection Committee with a sense of the direction the applicant anticipates that his or her career is heading with respect to professional goals. There is no requirement of a 5 year commitment to the organization.

2) Can the NPO provide applicants with some guidelines on how to approach their home institutions for support?
The applicant's proposed project should be looked at as a bridge between the PCF program and the home institution. The benefit of the project to the home institution and its core business should be clearly articulated in the applicant's proposal and in the letters of support from the applicant's supervisor or other organizational leaders. The NPO is looking for evidence that home institutions are interested in organizational change and willing to make these changes. This evidence should also be provided through the cost share commitment.

3) If the proposed project will benefit a partner outside of the applicant's home institution, how should the support of the outside partner be shown in the application?
The third letter of recommendation can be provided by an individual from this outside partner. This letter can detail the partner's commitment to the project; however, the outside partner does not need to provide any financial commitment.

4) How should the home institution's required cost sharing be reflected in the budget?
The budget should specify the how the $45,000 per year from the Practice Change Fellows award will be allocated over the two years. The budget should also detail how the $45,000 cost sharing over the two years will be met. Between the $90,000 provided by the PCF program and the $45,000 from the home institution, the budget total should be at least $135,000.

5) If an applicant has a joint appointment, should their letters of support come from the organization where the majority of their work is done?
This depends on the applicant's relationship with both organizations. It is important that each organization provide at least one letter of support. Letters should address what, if any, track record the organizations have in terms of prior collaboration. For PCF program purposes, the home organization should be the one that provides the majority of the cost-share support.

6) What should be the focus of the outside letter of recommendation?
This letter should come from an individual who is familiar with the applicant and should comment on the applicant's characteristics, leadership potential, and strengths.

7) To what degree should line item costs on the budget support the project versus be directly related to the project?
The items included in the budget should be directly related to costs that are necessary for developing leadership skills and completing the project. For example, a laptop for someone in the applicant's organization to help collect data would be an acceptable item to include in the budget.

8) Should travel to the tri-annual meetings be included in the budget?
No. Travel expenses, including transportation, lodging, and meals will be paid for by the program and do not need to be included in the budget. Travel and associated expenses for the leadership training course, however, should be included in the budget.

9) Should the application be written in the first or third person perspective?
Either is fine. The application should use an active voice rather than a passive one, however. It should be clear who is performing the action.

10) If an applicant has identified his or her own specific learning needs, should these be included in the application?
Yes, this can be built into the description of what the applicant hopes to get out of the program.

11) Can the proposed budget be modified during the course of the program?
The NPO recognizes that the initial proposal may need some modifications as projects get underway, and will accept these based on certain boundaries. However, the general categories built into the proposal should remain similar.

12) Can the budget include coursework that the applicant would like to take that will help them in their project development?
Yes, additional coursework is an acceptable budget item if it helps the applicant fulfill their leadership development goals. The expectation is that any leadership course or program has a strongly practical (as opposed to theoretical) emphasis. The coursework can be taken in conjunction with the formal leadership training requirement. Taking a single class at a university, however, would not, replace the formal leadership training requirement.

13) Can applicants submit more than three letters of support?
Applicants are strongly encouraged to submit only three letters.

14) Can references and diagrams be attached to the application?
References and diagrams are not required, and if included will be counted as part of the page limits (i.e., no additional pages or appendices are allowed).

15) If applicants are not selected for this year's PCF class, are they eligible to reapply?
Yes. While the NPO will be unable to provide individual feedback to applicants, those that were not selected are encouraged to look at the applicants and projects that were selected (on the Practice Change Fellows website) and, if necessary, refocus their application for submission for the next PCF class.

16) Can program funds cover the salary and benefits for the Fellow?
Fellowship funds may be used to pay the Fellow's salary and benefits for up to 20% of their time, and applicants should quantify this in their proposed budgets. Though the exact allocation of fellowship monies is not prescribed, it is expected that the Fellow's salary and benefits will not be the sole budget line (i.e., there will also be support for project related expenses).

17) If my project entails partnering with organizations external to my home institution, would it be an acceptable use of program funds to subcontract with these partners?
Yes, applicants should indicate in their proposed budgets if particular tasks or deliverables will be subcontracted out to other organizations.

18) How should applicants demonstrate that they possess adequate operational influence within their organizations?
Applicants may wish to describe their particular positions by highlighting accomplished or successfully coordinated programs, or by itemizing core responsibilities and direct reports. Applicants should demonstrate to the selection committee their ability to directly improve care to older adults.

19) If the applicant has applied for another grant to supplement the proposed Practice Change Fellows project, should this be addressed in the application?
Yes. The applicant should outline how the allotment of resources will change if both awards are granted. The applicant is also encouraged to propose a contingency plan should the supplemental funding not be awarded or become delayed.

20) Which component of the application carries the most weight?
The selection committee will examine the leadership potential of the applicant, the potential impact of the proposed project, and the environment in which the applicant will conduct the project. All components of the application will inform the selection committee's evaluation.

21) How does the program distinguish between the applicant's need to develop leadership skills versus the requirement of already having enough influence within their organization to make decisions?
Strong applicants will have had some exposure to leadership training and enough real world experience to be able to articulate their strengths and weaknesses, and to know in which areas they need improvement.

22) Is it better for the letters of support to come from individuals in senior positions or those who are actually working in the trenches?
The most important factor is what the letter says about the applicant - content carries as much weight as the writer.

23) Can a portion of the cost-share come from an external community partner or must the entire amount come from the home institution?
As long as it is clear in the application that the community partner is formally invested in the project (for example, provides a letter of support for the applicant), it is acceptable for the community partner to assume a portion of the cost-share.


1) If I am accepted, can I change my project?
Fellows are strongly encouraged to complete their projects as proposed. Under extenuating circumstances, the NPO will consider an alternative proposal.

2) Will there be opportunities for applicants to receive feedback on their project proposals before submitting their final applications?
If the applicant has two possible projects in mind, the National Program Office (NPO) will be happy to provide advice on which may be a better fit for the program. However, the NPO will not provide critiques of the actual proposal.

3) Will both the planning and implementation of the Fellow's project take place within the two year duration of the PCF program, or is the two year period only for planning, with implementation occurring after program completion?
Within the two year period, the project should be circumscribed enough to be able to complete collection and analysis of outcomes. Applications may address the steps that will occur after the two-year period to show that the project has longevity and isn't in isolation to the other work of the organization.

4) Does the project need to be medical/clinical in nature?
The proposed project should focus around improving the health status of older individuals. It can be focused on chronic illness, health promotion, preventive health, mental health, physical or cognitive function, or innovative approaches to delivering health care.

5) Should part of the proposed project include developing measures of the outcomes?
The overarching goal for the project or service line is to identify and assess process and outcomes measures that are meaningful and compelling to senior leadership. The ultimate measure of success is sustained support for the new program or service line. Lastly, the projects should be of a size and scope that allows them to be completed in two years. This constraint may have additional implications for what is and is not realistic for measurement.

6) If a Fellow's project utilizes a program that already has an evidence base, can they use the data measures that have already been developed?
Yes, particularly if they are relevant and the home institution leaders are compelled by these measures to support the program or service line.

7) Do the terms "geriatric service line" and "program" include interventions that may be embedded in existing practice, such as clinical tools and strategies used by clinicians, or do they refer to projects that are add-ons, and may require new staff?
Please interpret terms such as "program" or "service line" in a broad context. Either of these approaches would be acceptable.

8) Are there any additional guidelines applicants should keep in mind when thinking about their projects?
The proposed project should have measurable outcomes, either in terms of how it helped improve the health of older individuals or the cost savings. Projects should not be so unique that they help the individual organization but are irrelevant to outside institutions.

9) Can the applicant pursue a project in a particular area in which s/he has already been working?
This is acceptable provided that the applicant describes the proposed project's unique contribution to this body of work, as well as why the proposed project is the next logical step.

10) Should the projects require human subjects/institutional review board approval?
No. The projects are intended to be quality improvement oriented rather than traditional research in which case approval would not be required. Fellows who wish to publish their results in peer-reviewed journals (not required by the program) may consider getting approval prior to initiating their projects.

11) Is there an anticipated timeline for a Fellow's progress with their project during the two years of the program?
Ideally the projects should be narrow enough in scope to be accomplished in the two years. This includes implementation, measurement, and analysis. If the project ends up being completed in less than two years, Fellows may continue to use program support for the next steps.

12) Are there any requirements regarding whether the project provides direct care versus one that trains people to provide that care?
These should be front line projects, directly affecting the health and health care of older adults. Projects that primarily aim to coordinate in-services are not a strong fit for this program. However, models that secondarily incorporate an educational component into a broader program aimed at creating systems-level change would be appropriate.

13) What services would be considered as a "geriatric service line" or "aging program"?
Services are not limited to hospitals or clinics. The selection committee will consider a broad array of services affecting the health of older adults. These could include acute, long term, and home care in addition to health promotion, prevention, or end of life care. Projects that are directed primarily at social services rather than health or health care services would not be competitive.

14) Will Fellows be expected to make their projects available to a wider audience?
The National Program Office will promote successful projects via the Practice Change Bulletins. In this manner, Practice Change Fellows' projects will ideally influence care outside of their home institutions.

15) Can the proposed project be the development of a product that is an extension of a current project?
Yes, projects that build off of current projects are acceptable. These should be quality improvement projects rather than traditional academic research, and should be practical and have direct application.

16) Under what circumstances would Fellows be allowed to change their project?
Projects should be designed with an expectation of continuity through the two years, and changing projects is discouraged. However, it is understood that health organizations and health care delivery are not static, and Fellows may need to make mid-course modifications to their projects. This may be acceptable as long as the general focus of the project stays the same. All changes are subject to approval by the National Program Office.

17) If the proposed project includes the implementation of a program that will create a revenue stream, can the revenue be included as part of the cost-share requirement?
Since the revenue stream will not be predictable when the application is submitted, it will be hard to include a firm number as the cost share contribution. The selection committee will be looking for confirmed contributions.

18) Should projects be replicable on a community or institutional level?
Either will be acceptable.

19) Please provide more detail regarding the size and scope of the projects.
The project should be designed for a specific audience, and should aim to follow a design that will produce outcomes meaningful to that audience. The selection committee will be expecting applicants to have a good understanding of their environment and what process and outcome measure will be relevant and compelling to the leaders who will decide whether or not to support sustained funding for the new program or service line.

20) What should be the target population for projects?
The size of the target group will vary depending on what is appropriate and relevant to the environment in which the project will be implemented. The projects should target older adults, 65 years and older. If the target group needs to include individuals outside of that age group, please provide the reasoning for that decision in the application. The target group should not consist only of individuals outside of that age group, however.

21) How long should the proposed projects take to complete?
The NPO understands that time may be needed (e.g. 2-3 months) at the start of the project to get things in order, as well as at the conclusion of the project to complete the final analyses and put together a compelling presentation of findings (e.g. 2 months). Thus applicants should aim for a project that requires approximately 18 months to complete. If the proposed project timeline is less than one year, it is suggested that applicants look at incorporating a phase 1 and phase 2 in order to take advantage of the two year time period of the program.

22) For the project description, is an overview better or should applicants provide more detail?
The selection committee will look at the applicant's thought process in determining the steps involved in the proposed project. They will also look for evidence of how the proposed project will help the applicant further develop or refine leadership skills. Applicants should make sure they show how the project will be a vehicle to build their leadership skills.

23)Should the proposed project design a new program or adopt an established program with an proven evidence base?
Either is acceptable. If the latter is proposed, the applicant needs to address the inherent challenges of translating innovation into practice in general and within their home institution in particular.

24) Where can I find descriptions of current Fellows' projects?
Links to current Fellows' project descriptions can be found here.

25) How should applicants address the issue of project sustainability in the context of stakeholders outside of their home institution?
Demonstrating that you have considered the perspective of potential adopters is important. You may choose to cite any prior experiences (of your own or those of others) that contributed to successful adoption. You may also request a letter of support to from a potential adopter that suggests relevant criteria for considering adoption of the project.

26) Does the selection committee prefer to see projects addressing particular issues, particularly those that are national priorities?
The selection committee will consider both creative and novel initiatives as well as those focusing on widely-recognized national priorities.

Leadership Training

1) Please clarify the leadership training that Fellows will be required to receive.
Practice Change Fellows are encouraged to select a formal leadership training program that best meets their needs. The NPO will offer a "menu" of programs from which Fellows can choose; however the NPO does not formally endorse any one leadership program. Fellows are also welcome to identify options that are not included in this menu, including those programs that are offered locally. Either way, Fellows are strongly encouraged to attend a program that provides practical skill development which directly addresses their immediate need(s) for professional growth rather than a program that is heavy on theory or academic principles. The NPO recognizes that the formal leadership programs differ with respect to the time commitment involved, the cost of attending, and the level of competitiveness to be selected to participate. Applicants are encouraged to consider these factors in their budget proposals.

2) Can applicants identify a formal mentor or take an online course in lieu of the formal leadership program, or is a course at a college or university required?
We envision that the leadership program will be a brief (1-2 week) intensive leadership experience that is highly focused on practical "hands-on" (rather than academic) learning. If an applicant is not in a position to be away from their professional or personal responsibilities for this period of time, it is acceptable to take advantage of a local leadership offering, provided that this local offering directly supports the individual in achieving the objectives they have established for their own professional growth. An on-line course may also be acceptable with the same caveats. Applicants may attribute a portion of their budget to support an external formal mentor for longitudinal teaching or coaching. However, this would be seen as an adjunct to formal leadership training rather than a replacement.

3) What are examples of acceptable leadership training programs?
The Practice Change Fellows program does not endorse any particular leadership training program. There are a wide range of programs that would be acceptable, and each has particular strengths and different levels of competition for acceptance. The training should target the areas of improvement the Fellow outlined in their learning contract. Training programs should take an applied and practical approach rather than an academic one. Applicants are not expected to have selected a leadership training program (or have been selected to such a program). Some examples of national training programs are available here.

4) Applicants are encouraged to attend a formal leadership training course, and are asked to include the cost of this in their budget proposal. If the applicant's home institution encourages enrollment in such a course and covers the accompanying costs, can this be considered an in-kind contribution and thus off-set some of the required cost-sharing?
Yes, this may be considered part of the home institution's in-kind support.

5) What are the guidelines for including the leadership training tuition in the budget proposal?
Tuition for leadership training programs varies widely and ranges from $5,000-15,000. It is acceptable to include an estimate of anticipated tuition as well as related travel expenses in the budget proposal, as in most cases the actual costs will not be not known. Since some of these programs require a formal application process, it is anticipated that most fellows will complete the leadership training in their second year in the program.

6) If an applicant has previously completed a leadership course, can that be used to fulfill the requirement?
If you have already taken a leadership course similar to what is required, please explain this in the application, and propose to take a course which would build on this experience and complement your professional goals. Do not omit the leadership training course from the proposed budget.

7) Are applicants required to list the exact leadership course they will be taking?
No, it is not necessary at this point to know the exact program. We do, however, expect applicants to be able to articulate specific leadership skills or attributes they hope to develop through participation. Also, make sure to include an estimated cost for attending such a program in your proposed budget.

Program Structure

1) How is the 20% time commitment requirement measured?
This requirement is an average over the 2 year program. The NPO understands that the time Fellows spend on PCF related activities will vary on a weekly basis.

2) How will the 1 day/week (20% of full time) be spent?
Since the Fellow's project should benefit the organization, ideally there will not be a sharp delineation between the Fellow's ongoing responsibilities and their work on their project. As the Practice Change Fellows program emphasizes "on the job training", re-entry issues are minimal. The NPO recognizes that the Fellow's time commitment to the project will vary from week to week, but should average to 1 day/week over the two year program.

3) If one individual from an organization is unable to devote the required 20% time to the program, can two individuals "share" a Fellowship?
Practice Change Fellow positions are reserved for individuals and cannot be shared amongst two or more persons.

4) Is the primary goal of the program to develop leadership skills or to implement a new geriatric program or aging service line?
Building leadership and designing/implementing a new geriatric program or aging service line are closely linked. The program or service line becomes a vehicle for developing new leadership skills, incorporating new tools, and gaining self-confidence. Beyond the home institution, the program or service line will ideally resonate with organizations across the country, further expanding its "reach". The Practice Change Bulletins will feature Fellow's progress on their projects and service lines, with particular emphasis on their broader relevance.

5) How long are the tri-annual meetings?
The tri-annual meetings will be 1.5 days long. The meeting location will rotate among different cities across the country.

6) Are the Fellows expected to attend all of the tri-annual meetings?
Yes, Fellows are expected to attend all of the tri-annual meetings (a total of six meetings over two years). The meetings are designed to be highly interactive and will include dedicated time for Fellows to discuss their progress within a mentoring group. Each Fellow will be required to present at one meeting per year. These presentations will summarize project progress: what has been accomplished, what is going well, and which areas others may be able to help with. These presentations will be compiled into Practice Change Bulletins that will be made available on the website following the meetings.

7) What will be the relationship between the Mentors and the Fellows?
Each Fellow will be matched with one Mentor based on certain parameters that will ideally enhance compatibility. At each of the tri-annual meetings, there will be "pods" comprised of multiple Fellows and multiple Mentors. The goal is to have everyone act in the role of both teacher and learner.

8) Can applicants spend more than 20% of their time on the PCF program?
Applicants should work this out with their home institutions. No additional PCF support will be provided for individuals who devote more than 20% of their time (on average) to the program.

9) Should the required 20% time commitment be entirely administrative or can it also include clinical work if that is a necessary component of the project?
The 20% portion of the Fellows time that is allotted to the PCF program should be spent on leadership activities, such as running the project, attending the tri-annual meetings, attending a national leadership training course, completing program assignments, etc. Direct clinical care would not be included in that time allotment.

10) Is it necessary to use outside consultants?
While it is acceptable to include outside consultants in the proposed budget, taking advantage of any internal resources is a good way to meet the cost-share requirement.


1) Is a list of potential mentors available?
No, but it is useful for applicants to look at the members of the National Advisory Board, as the mentors will largely be drawn from these individuals. Applicants who do not identify with any member of the National Advisory Board may wish to re-examine their interest in applying.

2) Is there any relationship between the Practice Change Fellows program and the Respectability Project?
Not necessarily. The Respectability Project is administered through the National Council on Aging, but has a focus on civic engagement. In contrast, the Practice Change Fellows program has a stronger focus on health and leadership development. There is no formal link between the two programs, and individuals may apply to both.

3) Will the NPO provide support to nurture the network of PCF Alumni and Mentors beyond the two year program?
After completion of the program, there will be opportunities to network with other PCF Alumni. Alumni may have the opportunity to join the National Advisory Board and/or become mentors for incoming Fellows. The hope is that this network will become a strong voice for improving care to older adults.

4) Will the final selection of Fellows represent an even distribution among the three disciplines of Nurses, Social Workers, and Physicians?
The selection committee will not have any set quotas to follow, but the hope is that all three disciplines will be represented in the final selection of Fellows.