Pharmacy Advancement Initiative (PAI)
State Affiliate Grant
[Note: Pharmacy Advancement Initiative is based on the previous Pharmacy Practice Model Initiative (PPMI) and the Ambulatory Care Summit Recommendations.]
Categories of Attendee Types
Provide a list of the types (e.g. president, program chair, executives, board member, students, etc) of individuals who will participate in the proposed workshop. Use additional pages if necessary.
Supporting Documents Required
(a) COVER LETTER; and
(b) LETTERS OF SUPPORT FROM THREE KEY AFFILIATE LEADERS
Through these letters of support, affiliates leaders should discuss the organization's commitment to providing PAI-related programming to its members and address their personal support for the workshop and subsequent activities.
Certification and Acceptance
The undersigned agrees and understands that participation in this program is subject to the following terms:
1. The workshop and the subsequent state affiliate programming must be completed within one (1) year of disbursement of the grant:
2. Within 90 days of workshop completion, the grantees must submit an Interim Report to the ASHP Foundation. This report must include:
3. Within 90 days of completion of the program, the grantees must submit a Final Report detailing program accomplishments. The program accomplishments component of the report must summarize the activities that have been implemented to advance pharmacy practice in the state as a result of the workshop and include the number and percentage of hospitals completing the HSA.
4. Within 90 days of completion of the program, the grantees must submit a Final Financial Report that must include a complete accounting of the expenditure of ASHP Foundation funds related to the program offering.
5. Any unused funds greater that $100 must be returned to the ASHP Foundation by the grantee;
6. If, for any reason, the grantee does not provide the program, the state affiliate must inform the ASHP Foundation in writing within 30 days of program termination and return any unused funds to the ASHP Foundation as described above;
7. If presentation of the results of the workshop or the subsequent program is made at a national pharmacy meeting, the ASHP retains the right of first refusal presentation (s) that emanate from this program;
8. If the program results are submitted to a nation or international pharmacy journal for publication, the American Journal of Health-System Pharmacy retains the right of first refusal for publication. This does not include affiliate publications;
9. A reprint of all articles that emanate from this program should be submitted to the ASHP Foundation;
10. all presentations, publications, and other communications regarding this program must include following acknowledgment; "This program was funded (or partially funded) by a grant from the ASHP Research and Education Foundation."; and
11. By accepting this seed grant, the grantee will undertake all reasonable efforts to complete the work and take responsibility for fulfilling the terms described within the grant letter.
(By typing your name below, you are providing an electronic signature. This signature certifies that all the submitted information is accurate and you agree to all of the above.)
APPLICATIONS WILL BE ACCEPTED ON AN ONGOING BASIS