CTSI Designated Core Application

Core Name

Core Director

Core Director e-mail

Core Director phone number

Please upload a current biosketch for the director

Is there an Associate Director

Please upload a biosketch for the Associate Director

Name of Associate Director

Campus where your core is located

If other, please provide campus location

Location Building and room number

Narrative Description of the core: The description should clearly articulate the justification for designation as a core that "provides a needed service to investigators from more than one department". This description should include a) a description of the services that the core provides to investigators and the reason for providing these services in a core setting; b) a description of (i) specialized equipment and/or (ii) distinctive expertise that the core provides to investigators, including a description of the role of key personnel; c) the current or anticipated users of the core, including a list of users representing at least 2 different departments and a description of how the core services contribute to the ongoing or future projects for at least 4 users.

How many current users do you have from Indiana University School of Medicine?

How many current users do you have from IUPUI who are outside of the IU School of Medicine?

How many current users do you have from IU Bloomington?

How many current users do you have from Purdue University?

How many current users do you have from University of Notre Dame?

Please provide a list of all users outside of the CTSI institutions as named above and provide the institutions/affiliations for each.

Core Funding Approach: Identify for each key staff member and piece of core equipment central to the function of the core what fraction of the time will be available to investigators paying user fees versus what fraction is committed to specific projects, investigators or centers that provide funding directly to the core.

Provide a document listing your menu of services and approved charge-backs for each.

Do you offer tiered rates?

Please provide the guidelines used for application of each of your rate tiers

Please describe the circumstances you would provide partial or full refunds, if applicable.

Please describe the circumstances you would accept partial payments, if applicable.

Please describe circumstances you would waive payments, if applicable.

Please describe your method of collecting payment from external users, if applicable.

Have your rates been approved by the Business Office and/or University officials?

What business/university office has approved your rates?

Describe your plans for having your rates approved

What is the name of your core advisory committee chair?

Is the chair of your committee outside of the core?

Your core advisory chair is required to be outside of your core. If there is reason that you cannot modify your advisory committee to meet this requirement please explain.

Please list all other committee members (including at least three additional members, one of which must be a technical adviser). For each member (1) list the home department of the member, and (2) note if they are (a) within the core or not, (b) a core user or not (c) a technical adviser or not.

What is the frequency of meetings

Please provide a sample agenda for your meetings demonstrating that you discuss each of the following:
i) Core utilization
ii) Core quality assessment/user satisfaction
iii) User fees
iv) Suitability of new services and equipment purchases
v) Advise regarding funding opportunities

Please describe your method for ensuring that the Advisory Chair and/or Director communicates a summary of the above advisory committee items to the responsible Department Chair /Center Director at least annually

Please upload your policy for confidentiality

Please upload your policy partial or waived payments

Please upload your policies for prioritization of work

Please upload your policy for Publication and authorship expectations

Please upload your policy for conflict resolution. (Scheduling, technical issues, authorship, quality, authorship, etc.)

Please upload a document demonstrating a quality and user satisfaction survey.

Describe regulatory considerations for your core and your approach to ensure compliance.

Which College / School, Division, Department or Center will be ultimately responsible for the financial shortfalls of the Core, if any?

Please upload a current organization chart showing the reporting hierarchy for the core facility to the institution

Please upload biosketches for any additional key personnel in your core.

Please upload a document with the signatures:
(1) Core director with attestation that the application is accurate
(2) the Core Advisory chair with attestation that the core advisory committee will provide oversight as directed in the Core Advisory Committee section of this application and
(3) the official signing for department/center/division/school that accepts fiscal responsibility for the core