Changes such as change in work scope, change in key personnel, change of grantee organization, etc. always require prior approval by NLM Grants Management and Program Staff. Prior approval is required to rebudget funds awarded for trainee stipends as well as tuition and fees on NLM training grants or from patient care costs on traditional research grants. In most cases you may rebudget funds from one category to another without prior NLM Staff approval. However, there are some budget categories that do require prior approval to changes. For a complete list and explanation of actions that require NLM Grants Management and Program Staff prior approval, refer to Prior Approval Requirements, Section 8.1.3 for specific information.