Combat Casualty Care - Multi-Domain Lifesaving Trauma Innovations (MuLTI) Award

The summary for the Combat Casualty Care - Multi-Domain Lifesaving Trauma Innovations (MuLTI) Award grant is detailed below. This summary states who is eligible for the grant, how much grant money will be awarded, current and past deadlines, Catalog of Federal Domestic Assistance (CFDA) numbers, and a sampling of similar government grants. Verify the accuracy of the data FederalGrants.com provides by visiting the webpage noted in the Link to Full Announcement section or by contacting the appropriate person listed as the Grant Announcement Contact. If any section is incomplete, please visit the website for the Dept of the Army USAMRAA, which is the U.S. government agency offering this grant.

Combat Casualty Care - Multi-Domain Lifesaving Trauma Innovations (MuLTI) Award: The JPC-6/CCCRP expects to allot approximately $10.7 million (M) of the FY19, $9.9M of the FY20, and $9.5M of the FY21 DHP RDT&E appropriations to fund approximately 12 to 30 FY19 DMRDP JPC-6/CCCRP MuLTI Award proposals/applications, depending on the quality and number of proposals/applications received. Funding of applications received in response to this BAA is contingent upon the availability of Federal funds for this program. The funding estimated for this BAA is approximate and subject to realignment. Proposals/Applications received in response to both the FY19 DMRDP JPC-6/CCCRP MuLTI Award extramural BAA and intramural Funding Opportunity Announcement will be evaluated and considered for funding together. The Government reserves the right to fund any combination of extramural and/or intramural proposals/applications. The anticipated total costs (direct and indirect) budgeted for the entire period of performance for an FY19 MuLTI Award will not exceed: • $2.5M total costs for studies involving prospective accrual of human subjects and clinical trials • $1.0M total costs for all other research Refer to Section II.D.6, Funding Restrictions, for detailed funding information. The USAMRMC executes its extramural research program primarily through the awarding of contracts and assistance agreements (grants and cooperative agreements). The type of instrument used to reflect the business relationship between the organization and the Government is at the discretion of the Government, in accordance with the Federal Grant and Cooperative Agreement Act of 1977, as amended, Title 31 United States Code Sections 6301-6308 (31 USC 6301-6308), which provides the legal criteria to select a procurement contract or an assistance agreement. An assistance agreement (grant or cooperative agreement) is appropriate when the Federal Government transfers a “thing of value” to a “state, local government,” or “other recipient” to carry out a public purpose of support or stimulation authorized by a law of the United States, DoD FY19 DMRDP JPC-6/CCCRP MuLTI Award 10 instead of acquiring property or service for the direct benefit and use of the U.S. Government. An assistance agreement can take the form of a grant or cooperative agreement. If “no substantial involvement” on the part of the funding agency is anticipated, a grant award will be made (31 USC 6304). Conversely, if substantial involvement on the part of the funding agency is anticipated, a cooperative agreement will be made (31 USC 6305) and the award will identify the specific substantial involvement. Substantial involvement may include collaboration, participation, or intervention in the research to be performed under the award. A contract is required when the principal purpose of the instrument is to acquire property or services for the direct benefit or use of the U.S. Government. The award type, along with the start date, will be determined during the negotiation process. Please see Appendix 2, Section E of the General Submission Instructions for more information. Production and Testing of Prototypes (Contracts only): USAMRAA may include an optional line item for the provision of advanced component development or for the delivery of initial or additional prototype units. However, such a contract addition shall be subject to the limitations contained in Section 819 of the National Defense Authorization Act (NDAA) for Fiscal Year 2010, as modified in Section 811 of the NDAA for Fiscal Year 2015. This BAA may not be used to support fundamental basic research. For this BAA, basic research is defined as research directed toward greater knowledge or understanding of the fundamental aspects of phenomena and of observable facts without specific applications toward process or products in mind. This BAA may support preclinical research, clinical research, and Phase 0 and Phase I clinical trials/testing. A clinical trial is defined as a prospective accrual of human subjects where an intervention (e.g., device, drug, biologic, surgical procedure, rehabilitative modality, behavioral intervention, or other) is tested on a human subject for a measurable outcome with respect to safety, effectiveness, efficacy, and/or exploratory information. This outcome represents a direct effect on the human subject of that intervention or interaction. For further definitions, categories, and resource information for human subject research, see the Human Subject Resource Document provided at https://ebrap.org/eBRAP/public/Program.htm. Phase II and Phase III clinical trials for U.S. Food and Drug Administration (FDA) licensure of drugs and definitive/pivotal testing for device clearance by the FDA will NOT be permitted under this BAA. Recruitment Milestones: For research involving human subject enrollment, the proposal/application must indicate the quarterly enrollment targets across all sites in Attachment 5: Statement of Work. Successful applicants will work with USAMRAA to establish milestones for human subject recruitment. Continued support for the project will be based upon satisfactory progress in meeting the established milestones. Research Involving an FDA-Regulated Drug, Biologic, or Device: If the study proposed involves the use of a drug or biologic that has not been approved by the FDA for the proposed investigational use, evidence that an Investigational New Drug (IND) application that meets all DoD FY19 DMRDP JPC-6/CCCRP MuLTI Award 11 requirements under the Code of Federal Regulations, Title 21, Part 312 (21 CFR 312) has been submitted or will be submitted to the FDA within 60 days of award is required. If the investigational product is a device, evidence that an Investigational Device Exemption (IDE) application that meets all requirements under 21 CFR 812 has been reviewed and approved by the FDA has been submitted or will be submitted to the FDA within 60 days of award is required. The Government reserves the right to withdraw funding if the IND or IDE application has not been submitted to the FDA within 60 days of the DoD award date or if the documented application status of the IND or IDE has not been obtained within 12 months of the award date. Multi-Institutional Clinical Trials: If the proposed clinical trial is multi-institutional, plans for the multi-institutional structure governing the research protocol(s) should be outlined in Attachment 14: Study Personnel and Organization. The lead organization responsible for developing the master protocol and master consent form should be identified and should be the single point of contact for regulatory submissions and requirements. A single Institutional Review Board (IRB) or Ethics Committee (EC) pathway is strongly recommended whenever possible. The master protocol and consent form must be reviewed by the USAMRMC Office of Research Protections (ORP) Human Research Protection Office (HRPO) prior to distribution to the additional sites for IRB/EC review. Communication and data transfer among the collaborating institutions, as well as how specimens and/or imaging products obtained during the study will be handled, should be included in the appropriate sections of the proposal/application. A separate intellectual and material property plan agreed upon by all participating institutions is also required for multi-institutional clinical trials. Research Involving Human Anatomical Substances, Human Subjects, or Human Cadavers: All DoD-funded research involving new and ongoing research with human anatomical substances, human subjects, or human cadavers must be reviewed and approved by the USAMRMC ORP HRPO, prior to research implementation. This administrative review requirement is in addition to the local IRB or EC review. Local IRB/EC approval at the time of submission is not required. The HRPO is mandated to comply with specific laws and requirements governing all research involving human anatomical substances, human subjects, or human cadavers that is supported by the DoD. These laws and requirements will necessitate information in addition to that supplied to the IRB/EC. Allow a minimum of 2 to 4 months for HRPO regulatory review and approval processes. Additional time for regulatory reviews may be needed for clinical studies taking place in international settings. When possible, protocols should be written for research with human subjects and/or human anatomical substances that are specific to the DoD-supported effort outlined in the submitted proposal/application as a stand-alone study. Submission to HRPO of protocols involving more than the scope of work in the DoD-funded award will require HRPO review of the entire protocol (DoD and non-DoD funded). DoD human subjects protection requirements may be applied to non-DoD funded work and necessitate extensive revisions to the protocol. Refer to the General Submission Instructions, Appendix 1, Section B, and the Human Subject Resource Document available on the eBRAP “Funding Opportunities & Forms” web page (https://ebrap.org/eBRAP/public/Program.htm) for additional information. If the IRB determines that a trial presents greater than minimal risk to human subjects, the DoD requires an independent research monitor with expertise consistent with the nature of risk(s) identified within the research protocol. If applicable, refer to the General Submission DoD FY19 DMRDP JPC-6/CCCRP MuLTI Award 12 Instructions, Appendix 1, Section B, for more information on study reporting authorities and responsibilities of the research monitor. Research Involving Animals: All DoD-funded research involving new and ongoing research with animals must be reviewed and approved by the USAMRMC ORP Animal Care and Use Review Office (ACURO), in addition to the local Institutional Animal Care and Use Committee (IACUC) of record. IACUC approval at the time of submission is not required. Specific documents relating to the use of animals in the proposed research will be requested if the proposal/application is selected for funding. The ACURO must review and approve all animal use prior to the start of working with animals, including amendments to ongoing projects. Principal Investigators (PIs) must submit the institutional animal use protocol, IACUC approval of that protocol, and a version of the animal use appendix titled, “Research Involving Animals.” Allow at least 3 to 4 months for ACURO regulatory review and approval processes for animal studies. Refer to the General Submission Instructions, Appendix 1, Section B, for additional information. Rigor of Experimental Design: All projects should adhere to accepted standards for rigorous study design and reporting to maximize the reproducibility and translational potential of preclinical research. Core standards are described in Landis, S.C., et al., A call for transparent reporting to optimize the predictive value of preclinical research, Nature 2012, 490:187-191 (www.nature.com/nature/journal/v490/n7419/full/nature11556.html). While these standards were written for preclinical studies, the basic principles of randomization, blinding, sample-size estimation, and data handling derive from well-established best practices in research and should be applied consistently across basic and translational studies. Projects that include research on animal models are required to submit Attachment 8, Animal Research Plan, as part of the proposal/application package to describe how these standards will be addressed. Applicants should consult the ARRIVE (Animal Research: Reporting In Vivo Experiments) guidelines to ensure relevant aspects of rigorous animal research are adequately planned for and, ultimately, reported. The ARRIVE guidelines can be found at https://www.elsevier.com/__data/promis_misc/622936arrive_guidelines.pdf. Use of DoD or Department of Veterans Affairs (VA) Resources: If the proposed research involves access to active duty military patient populations and/or DoD resources or databases, the proposal/application must describe the access at the time of submission and a plan for maintaining access as needed throughout the proposed research. Access to target active duty military patient population(s) and/or DoD resource(s) or database(s) should be confirmed by including a letter of support, signed by the lowest-ranking person with approval authority. If the proposed research involves access to VA patient populations, VA study resources and databases, and/or VA research space and equipment, VA PIs must have a plan for obtaining and maintaining access throughout the proposed research. Access to VA patients, resources, and/or VA research space should be confirmed by including a letter of support from the VA Facility Director(s) or individual designated by the VA Facility Director(s), such as the VA Associate Chief of Staff for Research and Development (ACOS/R&D) or Clinical Service Chief. If appropriate, the proposal/application should identify the VA-affiliated non-profit corporation (NPC) as the applicant institution for VA PIs. If the VA NPC is not identified as the applicant institution for administering the funds, the proposal/application should include a letter from the DoD FY19 DMRDP JPC-6/CCCRP MuLTI Award 13 VA ACOS/R&D confirming this arrangement and identifying the institution that will administer the funds associated with the proposed research. Access to certain DoD or VA patient populations, resources, or databases may only be obtained through collaboration with a DoD or VA investigator who has a substantial role in the research and may not be available to a non-DoD or non-VA investigator if the resource is restricted to DoD or VA personnel. Investigators should be aware of which resources are available to them if the proposed research involves a non-DoD or non-VA investigator collaborating with the DoD and/or VA. If access cannot be confirmed at the time of proposal/application submission, the Government reserves the right to withdraw or revoke funding until the PI has demonstrated support for and access to the relevant population(s) and/or resource(s). Refer to Section II.D.2.b.ii, Full Application Submission Components, for detailed information. Federal Interagency Traumatic Brain Injury Research (FITBIR) Data Sharing: The DoD requires that awardees make TBI research data generated by this award mechanism available to the research community through the FITBIR Informatics System. The FITBIR Informatics System is a free resource designed to accelerate research progress by allowing the storage, re-analysis, integration, and rigorous comparison of multiple datasets. Currently FITBIR eligible research include all studies generating prospectively collected human TBI subject data (e.g., clinical, demographic, phenotypic, imaging, and genomic). Data reporting to FITBIR is an opportunity for investigators to facilitate their own research and to collaborate with others engaged in similar research. While there is no direct charge to users of the FITBIR Informatics System, a project estimation tool (https://fitbir.nih.gov/jsp/contribute/fitbir-costs.jsp) is available to help estimate costs and manpower needs that may be associated with data submission. FITBIR guidance and policies, as well as the considerable advantages of FITBIR participation to the researcher, are detailed at http://fitbir.nih.gov/. In order to share data with FITBIR, three elements must be included in the proposed research: 1. Updated informed consent language that includes FITBIR data sharing. Sample consent language is included in Appendix III. 2. Global Unique Identifier (GUID): FITBIR encourages collaboration between laboratories, as well as interconnectivity with other informatics platforms. Such community-wide sharing requires common data definitions and standards. FITBIR allows for de-identification and storage of data (medical imaging clinical assessment, environmental and behavioral history, etc.) of various types (text, numeric, image, time series, etc.). Use of FITBIR's GUID system facilitates repeated and multi-user access to data without the need to personally identify data sources. In order to generate a GUID for a subject, the following personally identifiable information (PII) must be collected in the proposed research: • Complete legal given (first) name of subject at birth • Complete legal additional name of subject at birth (if subject has a middle name) • Complete legal family (last) name of subject at birth DoD FY19 DMRDP JPC-6/CCCRP MuLTI Award 14 • Day of birth • Month of birth • Year of birth • Name of city/municipality in which subject was born • Country of birth Note that this PII is never sent to the FITBIR system. PII cannot be extracted from the GUID. Information on GUID compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations can be found at https://fitbir.nih.gov/content/global-unique-identifier. 3. Common Data Elements (CDEs): Research data elements must be reported using the National Institute of Neurological Disorders and Stroke (NINDS) TBI CDEs or entered into the FITBIR data dictionary as new, unique data elements (UDEs). For the most current version of the NINDS TBI CDEs, go to http://www.commondataelements.ninds.nih.gov. Assistance will be available to help the researchers map their study variables to specific CDEs and ensure the formats of the CDEs collected are compatible with the FITBIR Informatics System. Use of the TBI CDEs is required wherever possible in an effort to create standardized definitions and guidelines about the kinds of data to collect and the data collection methods that should be used in clinical studies of TBI. Use of UDEs is strongly discouraged and subject to program approval.