Cover Page Memory Box Program as part of NJMS Rutgers Department of Pediatrics Palliative Care Services to support families experiencing a neonatal or young child death at University Hospitals PI: Ona Fofah MD, Neonatalology NJMS/Rutgers University Hospital Newark NJ 07103 CO-PI: James M Oleske MD MPH, Pediatrics DAIIDS, MSB F572 Newark, NJ 07103
Total budget: $5,000.00 requested
Pediatric Innovative Clinical Program Seed Grants – Request for Proposals APPLICATION DEADLINE: FRIDAY APRIL 22, 2016 The RBHS New Jersey Medical School Department of Pediatrics is pleased to announce that Seed Grants for Innovative Clinical Care Programs are available to establish or enhance programs to treat and/or prevent diseases of children and adolescents. These grants are funded by the NJMS Pediatric Chair UPA Funds. These grants are specifically intended to partner NJMS pediatric faculty with faculty and/or healthcare providers in other departments, schools within Rutgers University or at affiliated institutions or hospitals (i.e., University Hospital, Newark Beth Israel); or with local or regional not-for-profit service organizations, to facilitate the acquisition of extramural support for new collaborative clinical programs. Priority will be given to proposals addressing the following areas:
Pediatric Palliative Care
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CURRICULUM VITAE FOR DR ONAJOVWE OLADIPO FOFAH
DATE:
07/25/2015
NAME: Onajovwe. O. Fofah, MD PRESENT TITLE: Assistant Professor / Director, Division of Neonatology OFFICE ADDRESS: Rutgers-NJMS, Department of Pediatrics, UH F189, 185 South Orange Avenue, Newark, NJ 07103 TELEPHONE #/E-MAIL: 973 972 6753 /
[email protected] EDUCATION: A. Undergraduate Graduate and Professional Comprehensive High School, Ayetoro Ayetoro, Ogun State, Nigeria Pre Med (Advanced Level) B.
Date Awarded 06/1979
Graduate and Professional University of Ilorin Medical School and University of Ilorin Teaching Hospital Ilorin, Kwara State, Nigeria. MBBS
Date Awarded 06/1984
POSTGRADUATE TRAINING: A. Internship and Residencies 1. Rotating Internship – Ogun State General Hospital, Ilaro, Ogun. State, Nigeria. July 1984 – June 1985 2. National Youth Corps Service, National Orthopedic Hospital, Igbobi, Lagos State, Nigeria. Senior House Officer in Orthopedics and Trauma July 1985 – June 1986 3. University of Medicine and Dentistry of New Jersey, New Jersey Medical School/ Children’s Hospital of New Jersey Newark, NJ Pediatrics Residency July 1992 – June 1995 B. Research Fellowships Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, New York. Fellowship in Neonatal and Perinatal Medicine July 1995 – June 1998
C.
Postdoctoral Appointments 1. Department of Pediatrics, University of Medicine and Dentistry of New Jersey, / New Jersey Medical School, Newark, New Jersey. Instructor in Pediatrics January 1996 – June 1998 2. 3.
Department of Pediatrics, University of Illinois Medical School, University of Illinois, Chicago, Illinois Instructor in Pediatrics 2005 through 2006 Department of Pediatrics, Rutgers-New Jersey Medical School, Newark, NJ 2
Assistant Professor/ Attending Neonatologist October 2005 – till present
ACADEMIC APPOINTMENTS: Department of Pediatrics, Rutgers - New Jersey Medical School, Newark, New Jersey. Instructor in Pediatrics January 1996 – June 1998 1. 2.
Department of Pediatrics, University of Illinois Medical School, University of Illinois, Chicago, Illinois Instructor in Pediatrics 2005 through 2006 Department of Pediatrics, University of Medicine and Dentistry of New Jersey/ New Jersey Medical School, Newark, New Jersey- University Hospital, Newark, NJ Assistant Professor/ Attending Neonatologist October 2005 – till present
HOSPITAL APPOINTMENTS: (If applicable) 1.
Maryland Specialist Hospital, Maryland, Lagos State, Nigeria. Senior Medical Officer July 1986 – December 1990
2.
3. 4. 5. 6.
Department of Pediatrics Northwest Illinois Regional Perinatal Center/ Rockford Health System / Rockford Memorial Hospital, Rockford, Illinois. Attending Neonatologist. July 1998 – October 2005 Department of Pediatrics, University Hospital, Newark, NJ Attending Neonatologist / Director Division of Neonatology October 2005 – till present Department of Pediatrics St James Hospital, Newark, NJ Attending Neonatologist October 2005 – March 2008 Department of Pediatrics Hackensack University Medical Center Hackensack, NJ January 2013 till present Department of Pediatrics Palisades Medical Center North Bergen, NJ January 2013- till present
PRIVATE PRACTICE (If applicable): Attending Neonatologist – Northwest Illinois Regional Perinatal Center/ Rockford Health System – Rockford Memorial Hospital, Rockford, Illinois. July 1998 – October 2005 LICENSURE: Illinois Medical License (license number 0036 – 097783) July 2014 New Jersey Medical License (license number 62230) June 2017 DRUG LICENSURE: CDS: Illinois CDS (336 – 058391) July 2014 New Jersey CDS (DO 6668300) October 2015 DEA: DEA (No BF 4533522) September 2016
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CERTIFICATION: ECFMG (Certificate No 0-462-605-7), No expiration FLEX (Certificate No 600118025), No Expiration Board Certified in Pediatrics, December 2002 Board Recertified in Pediatrics, December 2009 Board Recertified in Pediatrics, November 2012 Board Certified in Neonatal - Perinatal Medicine, December 2006 Board Recertified in Neonatal – Perinatal Medicine, December 2019 MEMBERSHIPS, OFFICES AND COMMITTEE ASSIGNMENTS IN PROFESSIONAL SOCIETIES: 1. American Academy of Pediatrics Member June 1992 2. Section of Perinatal Medicine- American Academy of Pediatrics Member, July 1998 3. New Jersey Chapter – American Academy of Pediatrics Member October 2005 4. American Academy of Hospice and Palliative Medicine Member July 2008 5. NJ State Neonatal Intensive Care Collaborative Team Leader January 2011 6. SID Center of NJ Member February 2015 HONORS AND AWARDS: 1. 2. 3.
Award of Excellence Pediatric Continuity Clinic, UMDNJ June 1995 Named one of Best Doctors in Northwest Illinois Rockford Register Star 2004 Attending of the year, Department of Pediatrics, UMDNJ Pediatric Residents, Class 2007 June 2007
4.
Nominated for Golden Apple Award – New Jersey Medical School 3 and 4 year Medical Students April 2007 Attending of the year, Department of Pediatrics, UMDNJ Pediatrics Residents, Class of 2010 June 2010
5.
6. 7.
rd
rd
th
3 Joe and Julia Quinlan Award Joe and Julia Quinlan Foundation May 2009 Best Teaching Attending Award UMDNJ-NJMS Emergency Medicine Residency, Class of 2011 June 2011 8. Miracle Maker-Health Honoree United Way of Essex and West Hudson May 2015 9. Castle-Connolly Top Doctor in Neonatal-Perinatal Medicine. 2015 BOARDS OF DIRECTORS/TRUSTEES POSITIONS: Trustee, Board of Directors; Circle of Life Children’s Center of NJ
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SERVICE ON NATIONAL GRANT REVIEW PANELS, STUDY SECTIONS, COMMITTEES: SERVICE ON MAJOR COMMITTEES: A. International (Name, Inclusive Dates) B. National Vermont Oxford Network Bi-annual Neonatal Intensive Care Quality project a National Evidence Based Quality Improvement Collaboration for Neonatology Member June 1999 – October 2005 C. Medical School/University: Admissions Committee, Member October 2006 till present D. Hospital Physician Advisor for Pediatric services - University Hospital’s Utilization Management Department. July 2008 till date E. Department (Name, Inclusive Dates) F. Editorial Boards (Journal Name, Inclusive Dates) G. AdHoc Reviewer (Journal Name, Inclusive Dates) SERVICE ON GRADUATE SCHOOL COMMITTEES: SERVICE ON HOSPITAL COMMITTEES: 1. Ethics Committee Member 2007 till present 2. Critical Care Committee Member October 2010 till present 3. Utilization Committee Member September 2008 till present 4. Neonatology Critical Care Meeting –UH Chair, 2006 till present 5. Vermont Oxford Network Team at Rockford Memorial Hospital Core Member 1999 to October 2005 6. Safety Committee –NICU, Rockford Memorial Hospital Co – Chair June 2002 till October 2005 7. Infectious Disease Committee – Rockford Memorial Hospital Member 1998 to October 2005 SERVICE TO THE COMMUNITY: 1. State of NJ - Pediatric Palliative Care Committee Member July 2008 till date 2. Neonatal Palliative Care Program Circle of Life Children’s Center, Newark NJ, 3. Associate Director October 2005 till date 4. March of Dimes Newark Breakfast Leadership Meeting Speaker August 2011 5. Center for African Community Services Health Task Force Newark, NJ July 2013 6. Essex County March of Dimes Walk for Babies Hospital Leader April 2014 7. Essex County March of Dimes Walk for Babies Co-Chair for walk for Babies April 2015 SPONSORSHIP OF CANDIDATES FOR POSTGRADUATE DEGREE: SPONSORSHIP OF POSTDOCTORAL FELLOWS: TEACHING RESPONSIBILITIES: (Teaching effectiveness should be addressed in nominating letter) A. Lectures or Course Directorships School, course name, lecture title, hours B. Research Training Postdoctoral Fellows: name, dates (inclusive) of training Pre Doctoral Students: name, dates (inclusive) of training CLINICAL RESPONSIBILITIES: (Clinical effectiveness should be addressed in nominating letter) 1.
Director, Division of Neonatology
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2.
Service Attending in the Neonatal Intensive Care Unit (FICN and FIN) care, management and diagnosis of complex medical conditions affecting newborn infants including extremely premature newborn infants. Others include use of complex and advanced ventilators such as High Frequency Ventilator 3. Service Attending in the Newborn Nursery 4. Clinic Attending in High Risk Clinic where babies are followed up to 7years of age 5. Transport of sick newborn infants 6. Resuscitation and care of sick newborn infants in the delivery room and emergency room GRANT SUPPORT: (Please list newest or most current first) A. Principal Investigator 1. Infacare Pharmaceutical Corporation. 64 185-204. A Phase 2 Multicenter, Single Dose, Randomized, Double Blind, Placebo Controlled, Parallel Group Study Evaluating the Safety and Efficacy of Two Doses of Stannsoporfin in Combination with Phototherapy in Neonate. July 2014. $ 7046 per randomized patient with S500 start up money. B. Co-Investigator 1. Funding Organization, title of award, inclusive dates of funding, amount of award C. Pending 1. Funding Organization, title, proposed funding date, proposed award PUBLICATIONS: (Please list newest or most current first; published or accepted for publication only; should be segregated into the following categories) A.
B.
C. D.
E.
Refereed Original Article in Journal 1. Fofah O, Roth P. Congenital Nephrotic Syndrome presenting with cerebral venous thrombosis, hypocalcemia and seizures in the neonatal period. J Perinatol 1997: 17: 492-4. 2. Fofah O, Kamen A, Piscitelli J and Brion LP. Prediction of peak serum vancomycin levels from trough values in neonates. J of Investigate Medicine 1997: 17: 492-4. 3. Fofah O, Brion LP, et. al. Failure of prediction of peak serum vancomycin levels from trough values in neonates. Peds Infect Dis J March 1999: 18:(3) 299-301. 4. Fofah O, et al. Development of potentially better practices for the neonatal intensive care units as a culture of collaboration: accountability, respect and empowerment. On behalf of Care Group. Pediatrics, Vol. 111 #4 April 2003, e471-e481. Books, Monographs and Chapters 1. Fofah O, et al (2011) Providing Palliative and End of Life Care for children having Primary and Acquired Immune Deficiency Conditions. In J Wolfe, P Hinds and B Sourkes (Eds), Textbook of Interdisciplinary Pediatric Palliative Care. (pp 470 - 479). Imprint: Saunders. ISBN: 978-1-4377-0262-0 Patents Held 1. Title, U.S. Patent Number, Date of Issue, Inventors Other Articles (Reviews, Editorials, etc.) In Journals; Chapters; Books; other Professional Communications 1. Authors names (Last, First; Bold CV author); Title of Article; Journal Name, Volume#: first-last page, year Abstracts 1. Fofah O, Igwe G, Oleske JM. Growth of Circle of Life’s Children’s Center of NJ (COLCC) Bereavement program 2006 to 2010.Presented at the 21st Children Hospice International World Congress in Washington DC October 2010 2. Igwe G, Fofah O, Walsh S, Oleske JM. Moral Distress in the Neonatal Intensive Care Unit: Care givers experience. Presented at the 21st Children’s Hospice International World Congress in Washington DC, October 2010. 3. Chystsiakova A, Fofah O, Monteiro I. Liver parenchymal injury in neonate with an umbilical venous catheter (UVC). Accepted for poster presentation at the NASPGHAN Annual Meeting, October 2011.
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4. Fofah O, Karmen A, Piscitelli J, Brion LP. Prediction of peak serum Vancomycin levels from trough values in neonates. Presented at A. Pediatric research day. AECOM, Wavehill, Bronx, NY. October 1997 B. Mead Johnson Nutritionals Greater New York conference on perinatal research. Long Island, NY Nov 1997 C. Montefiore Medical Center Young investigators research symposium, Jan 1998 D. Eastern Society for Pediatric Research, Feb 1998 5. Fofah O, Walsh S, Oleske JM. Perinatal and Neonatal Palliative Care: Circle of life experience presented at the annual National Perinatal Society meeting in Washington, DC July 2008 6. Millison N, Walsh S, Fofah O, Mayburry A, Oleske JM. Providing perinatal and pediatric Palliative and end of life care: Circle of life children’s center of NJ experience with cohort Of patients 2006 to 2008. Presented at the 19th Children Hospice International World congress San Francisco Nov 200 7. Fofah O, Walsh S, Maybury A, Oleske JM. Neonatal palliative care in an urban academic Medical center: Implementation, growth and development. Presented at the 19th Children Hospice International world congress San Francisco Nov 2008 8. Igwe G, Walsh S, Fofah O, Oleske JM. Neonatal pain: What nurses do and do not know. Presented at the 19th Children Hospice International world congress San Francisco Nov 2008 9. Chuang J, Campbell N, Walsh S, Fofah O, Oleske JM. Dealing with a challenging Adolescent with end stage AIDS. Presented at the 19th Children’s Hospice International World congress. San Francisco Nov 2008. 10. Fofah O, et al. Collaborative to decrease Central Associated Bloodstream Infection (CLABSI) in a Neonatal Intensive Care Unit: An Urban Academic Teaching Hospital Experience. Presented at the Association of Professionals of Infection Control, San Antonio, TX. June 3rd to 6th 2012 11. Fofah O, et al. Retention and Occlusion of PICC lines in a Neonatal Intensive Care Unit: An association with infusion pump. Presented at the 2013 Vermont Oxford Network Annual meeting and Quality Congress Conference in Chicago, IL. October 4th and 5th, 2013 12. Oleske. JO, Scolpino. AJ, Gianneschi GB, Dieudonne A, Holland BK, Fofah O, Desposito F, Dabis F, Makani J et al. Exploring the protective effect of the Sickle Cell Gene Allele on Perinatal HIV transmission and/or progression in US and Sub-Saharan Cohorts of Perinatally HIV exposed infants by Sickle Cell Gene status. Presented at RBHS Global Health Research Symposium, Piscataway, NJ. June 30th 2015 F.
Reports
PRESENTIONS: A. Scientific (Basic Science): B. Professional (Clinical): 1. UMDNJ –NJMS Project Pediatrics Speaker October 2010 2. Obstetrics and Gynecology Grand Rounds: Transition to Extrauterine Life October 28, 2010 UMDNJ-NJMS, Newark, NJ 3. Pediatrics Grand Round: Using Potentially Better Practices to Reduce the Incidence of Chronic Lung Disease; the University Hospital Experience. February 2011
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4.
University Hospital Quality Assurance Meeting: Therapies Directed at Reducing Chronic Lung Disease at University Hospital, November 2010 5. University Hospital Quality Assurance Meeting: The use of Potentially Better Practice to reduce Retinopathy of Prematurity February 2011 6. UMDNJ Respiratory Conference: The use of Potentially Better Practices to Reduce Chronic Lung Disease; what the Respiratory Therapist should know. September 2011. 7. Emergency Department Grand Round: Transition to Extrauterine Life- The Role of the Emergency Room Physician. January 2012. UMDNJ-NJMS, Newark, NJ. 8. Rutgers Respiratory Conference: The role of a respiratory therapist in the delivery room. May 2014. 9. Pediatrics Department Grand Round: A Newborn with Blue Berry Muffin Rash. April 2014 10. Pediatrics Department Grand Round: Acute Bilirubin Encephalopathy in a 10 day old. August 2014. 11. Department of PB-GYN Grand Round: Neonatal Outcomes at the edge of viability: The University Hospital Experience. August 2014 12. 5th Shanghai Neonatal Forum, Shanghai, China: Speaker on Transition to Extrauterine Life. April 9th -12th, 2015.
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Memory Box Program as part of NJMS Rutgers Department of Pediatrics Palliative Care Services to support families experiencing a neonatal or young child death at University Hospitals PI: Ona Fofah MD, Neonatalology NJMS/Rutgers University Hospital Newark NJ 07103 CO-PI: James M Oleske MD MPH, Pediatrics DAIIDS, MSB F572 Newark, NJ 07103 Specific AIMS: Supportive services provided by the Rutgers NJMS Dept. of Pediatrics-Palliative Care Program (PPCP) include the development of innovative services that include grief counseling, referrals to community programs that support parents and siblings, assistance with funeral arrangements and burial as well as the provision of memory boxes that contain precious keepsakes from the deceased infants. Funding from this proposal will support the continuation of such memory boxes to families experiencing the loss of an infant or child at University Hospital. Background, Significance, Innovation and Approach of Proposed Research: Pediatric age patients frequently do not receive adequate pain and/or symptom management, that are the bedrock of palliative care, nor do their families receive supportive services, the lack of which compromise quality of life.1 The initial cases of perinatal HIV infected infants and children from the 1980s were our first exposure to this unaddressed need exacerbated by the fact of that most of our families were uninsured or underinsured.2 Even those with health insurance would often not receive these services due to their lack of coverage under private or public insurance plans or availability of programs that adequately address the needs of the infants, children and adolescents with life-threatening conditions and their families. Currently, hospice programs generally limit their populations to adults who elect to forego curative care and have six months or less to live. Existing programs often do not serve children, particularly infants nor are they equipped or have staff trained to address the specific needs of infants and children with life limiting conditions. The frequent absence of a clear disease trajectory in infants and children has challenge pediatricians to state with certainty that a child is within six months of death, making adult hospice programs an inappropriate option for pediatric patients. The Pediatric Palliative Care Program (PPCP) in the Department of Pediatrics at NJMS Rutgers was established to address this critical gap at University Hospital (UH) in Newark, New Jersey where infants, children and adolescents with severe chronic, life-limiting illnesses and medical conditions frequently receive inadequate pain and symptom management which severely impacts them and their families' quality of life. PPCP also helped incorporate palliative care into the routine care for infants in the Neonatal Intensive Care Unit at U H, especially those with limits of viability. Most pediatric palliative and end of life services are currently not reimbursable through traditional insurance plans. Many of the families in need of these services are of low-income with little capacity to pay. Even those with insurance find that the critical end of life care services PPCP provides are often not covered by their specific health insurance plans. Eligibility for PPCP services are based on need alone for the services rather than ability to pay. These traditional palliative and end of life care services result in tangible benefits to providers and beneficiaries through: 1. Improved comfort care, pain management and quality of life for infants and children with chronic life-limiting diseases or conditions that are quantifiable. 2. Family relationships are stabilized through counseling and support for guardians and siblings who experience the stresses associated with chronic life limiting illness in a family member. 3. The quality and delivery of health care services is improved through coordination of care provided by PPCP among clinicians, patients, their families and healthcare systems. 4. The economic impact of providing quality end of life care significantly reduces the financial burdens by minimizing hospital admissions and length of stay, while assuring quality of care to one of New Jersey's most vulnerable populations.1, 2, 3 Proposal: PPCP in addition to providing palliative and end of life care to children also provides services that enhance pre/postnatal palliative and end-of-life care for infants born during adverse pregnancy that result in severe prematurity at the edge of infant viability, where infant mortality and/or prolonged neonatal intensive care result in 9
extreme duress for families. PPCP provides care for up to seventy five infants and their families per year at UH. In the case of extreme prematurity or spontaneous miscarriage, PPCP provides bereavement support to mothers and families that fosters resiliency and promotes adaptive coping for families who anticipate and/or have experienced the death of an infant. Additional supportive services provided by PPCP include the development of innovative services that include grief counseling, referrals to community programs that support parents and siblings, assistance with funeral arrangements and burial, provision of memory boxes that contain precious keepsakes from the deceased infants, and follow-up in subsequent months to determine if further assistance is necessary to ensure the stabilization of the family unit. An important additional role of PPCP at NJMS Rutgers and UH, is to educate physicians, nurses, and allied health providers regarding the importance of pediatric and perinatal palliative and end-of-life care, which includes education on appropriate disclosure of a significant illness, as well as how to discuss such devastating illnesses in an age appropriate way with the affected child and their siblings. This program was originally established in 2004 through the support of the nonprofit foundation: The Circle of Life Children Center (COLCC).4 COLCC founded and led by the current faculty with volunteer outside support, helped established the New Jersey Statewide Pediatric Palliative Care Consortium that is chaired by a COLCC trustee physician. Through its relationship with the Department of Pediatrics at Rutgers/NJMS and UH, the PPCP and COLCC programs participates in the development of an advanced syllabus for training in pediatric and perinatal palliative care at the Rutgers Biomedical Health Science programs in Newark, NJ and other pediatric palliative care programs in NJ. 4, 5 A major commitment of our PPCP is the provision of bereavement services which are provided to support women and their families who have gone through the experience of a loss of an infant or young child at UH 4, 5. We are requesting $5000.00 in support of the activities associated with PPCP inclusive of our post mortem loss activities both in and out of hospital. These services include creation of a Memory Box for mothers and family members who have experienced the loss of a premature or full term infant born at UH’s newborn service or young children cared for at UH’s pediatric services. The Memory Box provided to families suffering the loss of an infant or young child includes valued memory items: photographs, digital media, lock of hair, nursery blanket, knit cap and other memorabilia that would offer comfort to the mother and family. These items are presented in an appropriately decorative box prepared by the staff of our PPCP for pregnant women, infants, children and their families receiving services at UH in Newark, New Jersey. We require support for the materials required in construction of the Memory Box as well as the collection of materials being included in the Memory Box. In addition to the memory box, our PPCP also assists families in the difficult decisions with requests for autopsy and assistance with funeral/burial arrangements. All these activities require unfunded and unbillable supportive services by our PPCP physicians, nurses, social workers and staff. The mission of PPCP is to provide a comprehensive array of services and programs to our mostly underserved Newark community at UH that includes: in-patient and home-based perinatal, pediatric palliative and end of life care, professional consultation and education services, family support services, bereavement counseling, community and family education programs, and volunteer programs. Many of PPCP activities are not funded through traditional reimbursement mechanisms but have been found to be essential in the provision of palliative and end of life care services. The funding requested through the Pediatric Innovative Clinical Program Seed Grants will provide ongoing support for these essential palliative and end of life care activities while searching for more sustainable sources of funding. References: 1. American Academy of Pediatrics, http://www2.aap.org/sections/palliative/Mission.html 141 Northwest Point Blvd., Elk Grove Village, IL, 60007, 847-434-4000. 2016 2. Lyon ME., Williams PL., Woods ER, Hutton N., Butler AM., Sibinga E., Brady MT,, Oleske JM. Do-Not-Resuscitate orders and/or Hospice Care, Psychological Health, and Quality of Life among Children/Adolescents with Acquired Immune Deficiency Syndrome. J Palliative Med. 2008 MayJun: 11(3):459-69. PMID: 18363489; PMCID: PMC2782484
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3. Fofah, O., Fleck, M., Campbell, N., Walsh, S., Oleske, J., (2011) Primary and Acquired Immunodefiency Disorders. (pp 470-478) Textbook of Interdisciplinary Pediatric Palliative Care. Saunders. 4. Circle of Life Children’s Center: www.circleoflifenj.org/ 5. Oleske JM, Boland MG. When a child with a chronic condition needs hospitalization. Hospital Practice, 1997 167-181. PMID: 9194807.
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Memory Box Program Budget
Items
Qty
$
Total
unit
Memory Box
2
$75.81 $151.62
50/CS
Memory Box Top
2
$39.55
50/CS
300
$2.00 $600.00
75
$3.00 $225.00
$79.10
Memory Box Contents Keepsake Photo(s) Cradel cap Blanket 75
$5.00 $375.00
Nikon D3300 Digital SLR Camera Body (Black) with 32GB Card + Case + Flash + Tripod + Remote + Kit with NIKON USA Warranty - D3300BBKB-82915-Kit 1 $350.00 $350.00 1 Epson Stylus Photo R2000 printer Laptop Computer
1
1
$2,000.00
Family Travel Expanses re funeral
1
Total:
$700.00
$700.00
$2,000.00 $500.00
$500.00
$4,980.72
Budget Justificaiton All of the above requested materials are to support the preparation, contents, and memory items to be provided each family experiencing the loss of an infant or child.
List of Other Support There is no other support.
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Commitment Letter April 22, 2016 5pm To whom this may concern: All funds granted under this part shall be expended solely for the purpose for which the funds are granted in accordance with the approved application and budget. Sincerely,
Onajovwe. O. Fofah, MD PI James M. Oleske, MD MpH CoPI
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