Advancing the Science of Geriatric Palliative Care (R21 - Clinical Trial Optional) | PA 18 503

Opportunity Information: Apply for PA 18 503

Advancing the Science of Geriatric Palliative Care (R21 - Clinical Trial Optional) is a National Institutes of Health (NIH) funding opportunity designed to spark early-stage, exploratory research that can strengthen palliative care for older adults. Using the R21 mechanism, it focuses on developing and testing new tools, methods, and care models that are specifically relevant to geriatric populations, where serious illness, multiple chronic conditions, functional decline, and complex decision-making often make symptom management and care planning especially challenging. The intent is to support projects that are developmental in nature, meaning applicants can propose innovative ideas that may still be at the proof-of-concept stage, with the goal of generating solid preliminary evidence and practical approaches that can be expanded in later, larger studies.

A key feature of this FOA is its broad view of where geriatric palliative care happens. Research can be situated in hospitals and within specific hospital environments such as specialty medical or surgical wards, intensive care units, and emergency departments. It also welcomes work in post-acute care settings, outpatient clinics and physicians offices, patients homes and other residential settings, assisted living facilities, nursing homes, hospices, and other healthcare or community locations where older adults and their caregivers receive support. This flexibility signals that NIH is looking for palliative care solutions that can function across real-world systems of care, including transitions between settings that are common for seriously ill older adults.

The FOA encourages a wide range of study approaches that fit an R21 scope. Applicants may propose prospective studies that collect new data, but the announcement also explicitly supports analyses of existing datasets and records, such as health and medical records, insurance claims, and other secondary data sources. In practical terms, this means investigators can pursue questions about outcomes, quality of care, symptom burden, service utilization, and disparities using resources that already exist, which can be a fast and cost-effective way to generate impactful evidence. NIH also encourages applicants to leverage existing infrastructure, including ongoing cohorts, intervention studies, research networks, and data or specimen repositories. This emphasis on reuse and integration suggests that strong applications will often show they can build efficiently on prior investments and established platforms rather than starting from scratch.

In terms of design, the opportunity is intentionally open to multiple methodological paths. Studies may be observational, quasi-experimental, or include limited interventional components when feasible under the R21 framework. Because the FOA is labeled "Clinical Trial Optional," applicants are not required to propose a clinical trial, but they may do so if the research question and design meet NIH definitions and the scope is appropriate for an exploratory award. This structure is meant to accommodate everything from early testing of a new assessment tool or decision aid, to development of a care delivery model that could later be evaluated in a larger randomized or pragmatic trial.

From a funding and administrative standpoint, this is a discretionary grant program under NIH, tied to activity areas spanning education and health. The opportunity is identified as PA-18-503 and lists CFDA numbers 93.307, 93.361, 93.393, and 93.866. The listed award ceiling is $200,000, reflecting the smaller, developmental nature of R21 awards. While an "expected awards" figure is not provided in the supplied data, the ceiling indicates the program is meant to fund targeted, high-value exploratory work rather than large-scale multi-site trials.

Eligibility is broad and includes many types of organizations, which helps support innovation from both academic and non-academic settings. Eligible applicants include state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; and tribal organizations that are not federally recognized. It also includes nonprofits with and without 501(c)(3) status, public housing authorities/Indian housing authorities, for-profit organizations (other than small businesses), and small businesses. The FOA further highlights additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities, Tribally Controlled Colleges and Universities, faith-based or community-based organizations, eligible federal agencies, U.S. territories or possessions, regional organizations, and even non-U.S. entities (foreign organizations). Taken together, this suggests NIH is intentionally encouraging participation from diverse institutions and community-linked organizations that may be closely connected to populations experiencing serious illness and aging-related inequities.

Overall, the opportunity is best understood as a catalyst for new geriatric palliative care science: developing practical innovations, testing promising concepts in realistic settings, and using both new and existing data to identify what improves outcomes for older patients and their caregivers. The FOA is structured to reward feasibility, creativity, and smart use of existing resources, with the expectation that successful R21 projects will lay the groundwork for larger, more definitive studies and broader implementation efforts later on.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Advancing the Science of Geriatric Palliative Care (R21 - Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.307, 93.361, 93.393, 93.866.
• This funding opportunity was created on 2017-12-15.
• Applicants must submit their applications by 2020-09-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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