In developing your application, we encourage you to contact Kathleen Pike, PhD (kmp2@columbia.edu or 212.543.3671) or Harold A. Pincus, MD (pincush@nyspi.columbia.edu or 212.543.5401) with any questions or to discuss ideas.

Part I:  Applicant Information

Please provide the following information:

• Name
• Degree(s)
• Discipline/Professional Field
• Present Position
• Institution/Organization
• Work Address
• Home Address
• Telephone Number
• Fax Number
• Email Address
• Choice of Fellowship Track
  • Residential Only
  • Non-Residential Only
  • Either Residential or Non-Residential
  • Note:  If applying for either the residential or non-residential track, please indicate a preference for one track over the other, and complete questions #1-4 in Part IIA: Essays – Residential Track Applicants AND questions #3-5 in Part IIB: Essays - Non-Residential Track Applicants

• Please indicate which agency or agencies are of interest to you for your placement (please see information under "About the Fellowship- Partnerships"):
  • Congress - U.S. Senate and House of Representatives
  • Centers for Disease Control and Prevention (CDC )
  •  Centers for Medicare and Medicaid Services (CMS)
  • Office of the Assistant Secretary for Planning and Evaluation (ASPE)
  • National Institute of Health (NIH) and National Institute on Aging, (NIA)
  • Administration on Community Living (ACL)
  • Congressional Budget Office (CBO)
  • Congressional Research Service (CRS)
  • Office of the National Coordinator (ONC) for Health Information Technology
  • National Institute on Disability and Rehabilitation Research (NIDRR)/ Department of Education (DoE)
  • US Department of Veterans Affairs (VA)
  • Department of Transportation (DoT)
  • Department of Defense (DoD)
  • Environmental Protection Agency (EPA)
• Where/How You Learned About the Program

Part II: Essays

If you are applying for the Residential Track, please complete Part IIA.  If you are applying for the Non-Residential Track, please complete Part IIB.

Part IIA: Essays – Residential Track Applicants

Brief essays on the following topics: 

1. The reasons you want to be a Health and Aging Policy Fellow, including your strengths and qualifications for the program, your preference (if any) for a particular type of policy setting placement (e.g., Congress, executive agencies, policy organizations), the specific objectives you hope to achieve from this experience and how they relate to your professional goals. (Limit response to 3 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)
   
   

2. A description of your experiences and/or contributions in the health and aging field, either in your professional work or through community or volunteer service, and how they will contribute to your fellowship experience. (Limit response to 2 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)

   
   
3. A sample memo to a member of Congress on improving the health of older Americans, with a recommendation for a specific policy position. Explain why you think your recommendation is significant and why it should be supported? (Limit response to 2 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)   
      
4. Plans for continued development of your health policy leadership skills after you complete the fellowship. Explain how you will contribute to the development of health policy at the national, state or local levels, at your home institution or elsewhere, and how you envision the fellowship experience affecting your overall career goals and direction. (Limit response to 2 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)
   
   
   

(Once selected, the NPO will work with each fellow to identify appropriate projects, placements, and mentors. 

Part IIB: Essays – Non-Residential Track Applicants

Brief essays on the following topics:

1. The reasons you want to be a Health and Aging Policy Fellow, including your strengths and qualifications for the program, the specific objectives you hope to achieve from this experience, and how they relate to your professional goals. (Limit response to 3 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)
   
   
2. A description of your experiences and/or contributions in the health and aging field, either in your professional work or through community or volunteer service, and how they will contribute to your fellowship experience. (Limit response to 2 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)
   
   
3. Please describe the policy project you would like to complete during the fellowship term.  The project should focus on a topic that is in line with public-policy issues that your preferred organization(s) focuses on (please see information under "About the Fellowship-Partnerships"). The Health and Aging Policy Fellows Program does not support research or program implementation projects.  Your project description should include:
   • The policy topic on which you would like to work (e.g., policies to improve the quality of nursing home care, policies designed to increase the use of clinical preventive services, policy options for long-term care financing, policies to improve care coordination, policy options to enhance physical activity/transportation alternatives, etc.) with details on why this policy is important.
   • The specific objectives you wish to achieve and/or questions you hope to answer (e.g., identification of possible legislative or regulatory options, understanding of necessary coalitions to garner support, steps in the legislative process to move ahead, etc.).  How do you envision linking your policy project with a legislative component (e.g., Congressperson and/or Senators from your state, Congress, your state legislature, governor’s office, executive branch agencies in Washington, DC for implementation/regulation)?
   • Organizations and/or individuals with which it would be most appropriate for you to work on this project, i.e., the networks you would like to form.
   • Length of time/frequency and plan for short placement periods (if any) away from your current job.
   • Work plan and timeline for finishing the project.
   • How you plan for the results of your project to influence policy.  What would be your ideal result?
     (Limit response to 5 pages with 1-inch margins, 1.5 spaced, Times New Roman 12 point font.)
     
     
4.  Provide a line-item budget and narrative. Suggested budget categories might include:
   • Partial "buy out" of effort for the applicant
   • Travel to project-related meetings (e.g., trip to meet with their mentors and/or officials at various governmental agencies, e.g., CDC, CMS, NIH, and non-governmental agencies such as NQF, AARP, etc.)
   • Non-capital equipment and supplies or expenses directly related to successfully completing the project (e.g., long distance calls, postage)

Once selected, the NPO will work with each fellow to identify appropriate projects, placements, and mentors.

Part III: Supporting Documents

Please include:

1. Curriculum vitae
   
   
2. A one-page biographical sketch
   
   
3. The name and contact information for one institutional reference (e.g., department chair, supervisor, faculty mentor, agency or department director, etc.) whom you have asked to write a reference letter for you. The letter should:
   1. Address the selection criteria and your qualifications for the program
   2. Confirm the institution’s support of your participation in the program
   3. Describe the reference’s willingness to serve as your advisor by assisting with your growth as a health policy leader, if selected
   4. Describe any financial or in-kind resources the institution will make available to assist you during the fellowship placement (for residential track applicants) or to implement the proposed project (for non-residential track applicants).
      
      
4. The names and contact information for two professional references whom you have asked to write letters for you.  The letters should address the selection criteria and your qualifications for the program.

All reference letters should be sent directly to the NPO and received by the application due date of April 15, 2013.

Please email your completed application, CV and bio, and have reference letters sent to:

Harold Alan Pincus, M.D.
Director, Health and Aging Policy Fellows
Department of Psychiatry, Columbia University
1051 Riverside Drive, Unit 9
New York, NY 10032
healthandagingpolicy@columbia.edu

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