[Federal Register Volume 60, Number 35 (Wednesday, February 22, 1995)]
[Notices]
[Pages 9853-9855]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-4322]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Cooperative Agreement with the Pennsylvania Department of Health
AGENCY: Center For Substance Abuse Treatment, Substance Abuse and
Mental Health Services Administration (SAMHSA), HHS.
ACTION: Notice of a planned single source, cooperative agreement award
to support further development and continuation of a model
comprehensive substance abuse treatment demonstration program for the
City of Philadelphia.
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SUMMARY: The Center for Substance Abuse Treatment (CSAT), SAMHSA, is
publishing this notice to provide information to the public regarding a
planned single source competing continuation award to the Pennsylvania
Department of Health for the further development and operation of a
model substance abuse treatment demonstration program. The current
``Target Cities'' project period will be [[Page 9854]] extended for an
additional two years. The first year of the new cycle funding, fourth
year of operation, will be funded with approximately $2,500,000 in
federal funds. This is not a request for applications. The cooperative
agreement will be awarded to the Pennsylvania Department of Health only
upon receipt of a satisfactory application which is recommended for
approval by an initial review committee and the CSAT National Advisory
Council.
AUTHORITY/JUSTIFICATION: The competing continuation award will be made
under the authority of Section 510(b)(5) of the Public Health Service
Act, as amended (42 U.S.C. 290bb-3).
An award is being made on a single source basis in response to the
Senate Committee on Appropriations report 103-318, accompanying HR
4606, which has language that states: ``Sufficient funding has been
provided for CSAT to conduct an application cycle in fiscal year 1995
to extend from 3 to 5 years funding for the target cities grantee that
was funded out of the normal funding cycle in fiscal year 1991.'' The
report further states: ``The Committee expects the Center will maintain
an application criteria that is consistent with and that meets the
review standards and other requirements subject to target city
applicants in fiscal year 1993.''
BACKGROUND: In fiscal year (FY) 1990, the Office for Treatment
Improvement (CSAT's predecessor agency) initiated the Target Cities
Cooperative Agreement Demonstration Program to assist major
metropolitan areas with linking, integrating, and enhancing the
components of their addiction treatment and health and human service
systems in order to overcome the problems described below. In 1990,
eight target cities were funded for a three-year period. On June 1,
1992 a ninth target city was funded in Philadelphia, Pennsylvania. In
1993 a review cycle for target cities applications was conducted by
CSAT. In addition to new applications, each of the original eight
cities was given an opportunity to compete for a fourth and fifth year
of continuation funding. Because the Philadelphia target city was in
its second year of implementation, it was not eligible in 1993 to
compete for a fourth and fifth year of funding. In order to address
this lack of opportunity, and in response to the Senate Committee on
Appropriations report 103-318, referenced above, a competing
continuation application is being requested from the State of
Pennsylvania for the Philadelphia target city based on the guidelines
provided in the 1993 Program Announcement No. AS 93-07.
Many areas of the United States could benefit from additional
financial aid designed to improve access to high quality, effective
addiction treatment and recovery programs and related health and human
services. Some cities are facing demand for these resources in crisis
proportions.
Epidemiological data indicate that individuals who live near or
below the poverty line in large metropolitan areas tend to exhibit a
high prevalence of alcohol and drug use and a concomitantly high
incidence of addiction-related medical, psychological and socio-
economic problems. Escalating incidence rates for HIV/AIDS,
tuberculosis and sexually transmitted diseases in the metropolitan
areas are closely linked to alcohol and drug use, as are homelessness,
unemployment, crime and violence.
In most metropolitan communities, multiple factors have combined
over time to diversify and fragment the components of the health and
human services system rather than to integrate and facilitate the
provisions of services and case processing alternatives for those who
suffer from alcohol and drug problems. In almost all cases,
jurisdictions with high demand for addiction treatment and recovery
services have lacked sufficient resources for the enhancement or
expansion of diagnostic, coordinated case management and evaluation
efforts necessary to improve the effectiveness of the services
infrastructure. Of great concern from a public health perspective, is
that many addiction treatment and recovery programs do not have the
resources or appropriate linkages with health care facilities to ensure
that individuals with addictive disorders and their sexual partners are
screened and treated for HIV, tuberculosis, and other infectious
diseases.
In the context of complex and fragmented metropolitan systems of
health and human service delivery, it is not likely that the needs of
alcohol and drug-involved individuals and their families who live near
or below the poverty line will be addressed in a cost-effective manner,
for one or more of the following reasons:
(1) The system is not capable of concisely and comprehensively
assessing individual and family needs.
(2) The existing infrastructure is designed to provide
interventions on a discrete basis rather than to address the bio-
psycho-socio-economic needs of the individual and family as part of a
coordinated continuum.
(3) Individuals with alcohol and drug problems and their
collaterals are not capable of effectively negotiating the complexities
of a system composed of discrete, uncoordinated programs and are often
unable to locate the treatment program(s) that best suits their needs.
(4) Individuals may be turned away from programs that lack the
capacity to provide needed assistance, and may be unaware that there
are other treatment alternatives available within or adjacent to the
community in which they live.
(5) Individuals may be admitted to programs that are not capable of
addressing their unique needs or are not designed to provide services
in a cost-effective manner.
(6) Services may be delivered in a manner that is inconsistent with
the current racial, ethnic, cultural, socio-economic and practical
realities of the individuals and families who request assistance.
Since June 1992, the Philadelphia Target City Project has addressed
many of the problems discussed above by directly enhancing the public
drug and alcohol service system through eight inter-related components.
These components are a central intake unit, a management information
system, an enhanced case management system, provider staff
enhancements, training and staff development, project evaluation, and
two special initiatives. The special initiatives include a Labor
Initiative component that is implemented through the Department of
Labor's Job Training Partnership Act, and a CSAT Criminal Justice
Initiative. The Labor Initiative provides vocational assessment,
training and employment opportunities to individuals that have
successfully completed treatment. The Criminal Justice Initiative
provided funds for the development and implementation of a criminal
justice management information system (MIS). This MIS has coordinated
services and provided for the tracking of individuals through the
Philadelphia treatment and criminal justice systems. The criminal
justice MIS has provided for an effective system of early release from
criminal justice institutions to treatment providers. These components
provide patients access to treatment, standardized assessment, and
appropriate referrals to an enhanced, integrated, and comprehensive
treatment, medical and social service system. During the period of
project implementation 4,000 individuals have been assessed for
treatment services and 2,300 admissions to treatment have been
accomplished. This single source award is planned to continue the
development and implementation of a project that has
[[Page 9855]] successfully improved and enhanced substance abuse
treatment services for individuals receiving care through the publicly
funded treatment system in Philadelphia.
FOR FURTHER INFORMATION CONTRACT: Randolph Muck, Acting Chief, Systems
Improvement Branch CSAT/SAMHSA, Rockwall II, Room 618, 5600 Fishers
Lane, Rockville, MD. 20857. Telephone: (301) 443-8802.
Dated: February 16, 1995.
Richard Kopanda,
Acting Executive Officer, SAMHSA.
[FR Doc. 95-4322 Filed 2-21-95; 8:45 am]
BILLING CODE 4162-20-P
