[Federal Register Volume 64, Number 46 (Wednesday, March 10, 1999)]
[Notices]
[Pages 11915-11920]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-5866]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Notice of Meeting/Draft Program Announcement 99064]
National Center for Chronic Disease Prevention and Health
Promotion, Centers for Disease Control and Prevention Announcement of
Meeting
Name: Meeting for Public Comment on Racial and Ethnic Approaches to
Community Health Demonstration Projects (REACH).
Time and Date: 8:30 a.m.-3:30 p.m., March 16, 1999.
Place: Crystal City Marriott, 1700 Jefferson Davis Highway,
Arlington, Virginia 22202, (703) 920-3230.
Status: Attendees will include invited participants representing
private nonprofit organizations, academic institutions, State and local
health agencies, community health centers, Indian tribal governments
and organizations. The meeting is open to the public and is limited
only by space available. The meeting room will accommodate
approximately 150 people.
Purpose: Attendees will be charged with reviewing major concepts
and strategies that pertain to the Centers for Disease Control and
Prevention (CDC), National Center for Chronic Disease Prevention and
Health Promotion's pending funding announcement for REACH Demonstration
Projects. The funding announcement is in response to the ten million
dollars appropriated to the CDC by Congress in response to the Health
and Human Services Initiative to Eliminate Racial and Ethnic
Disparities in Health, which is aimed at eliminating disparities in
health outcomes for racial and ethnic communities in six health focus
areas by the year 2010.
Matters to be Discussed: Agenda items include discussion of
directly funding private nonprofit organizations (including community
based organizations and foundations); universities, colleges, research
institutions, and hospitals; governments and their agencies (including
State and local health agencies, and community health centers); and
federally recognized Indian tribal governments, Indian tribes, or
Indian tribal organizations; Public input and comments will be sought
regarding proposed recipient activities under Phase I/Phase II,
evaluation plan, and proposed CDC activities.
Due to administrative delays in the program, this notice was not
published fifteen (15) days in advance of the meeting.
Contact Person for More Information: Regina Lee, Office of Minority
Health, 5515 Security Lane, Suite 1000, Rockville, MD 20852, Attn:
REACH, OFFICE: (301) 443-9924, FAX: (301) 443-8280, EMAIL:
rlee@osodhs.dhhs.gov.
Racial and Ethnic Approaches to Community Health (REACH)
Demonstration Projects; Notice of Availability of Funds
SUMMARY
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 1999 funds for a cooperative agreement
program for organizations serving racial and ethnic minority
populations at increased risk for infant mortality, diabetes,
cardiovascular diseases, Human Immunodeficiency Virus (HIV), deficits
in breast and cervical cancer screening and management, and deficits in
child or adult immunization rates.
The purpose of this notice is to request comments on the proposed
program. A more complete description of the goals of this program, the
target applicants, availability of funds, program requirements and
evaluation criteria follows.
Dates: The public is invited to submit comments by March 24, 1999.
Submit comments to: Community Health and Program Services Branch,
Attn: Racial and Ethnic Approaches to community Health (REACH),
Division of Adult and Community Health, Centers for Disease Control and
Prevention (CDC), 4770 Buford Highway, NE, Mailstop K-30, Atlanta, GA
30333, or FAX: (770) 488-5974, E-mail address: ccdinfo@cdc.gov
For Further Information Contact: Letitia Presley-Cantrell,
Community Health and Program Services Branch Division of Adult and
Community Health, Centers for Disease Control and Prevention (CDC),
4770 Buford Highway, NE, Mailstop K-30, Atlanta, GA 30333, Telephone
(770) 488-5426.
A. Purpose
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 1999 funds for a cooperative agreement
[[Page 11916]]
program for organizations serving racial and ethnic minority
populations at increased risk for infant mortality, diabetes,
cardiovascular diseases, HIV, deficits in breast and cervical cancer
screening and management services, or deficits in child or adult
immunization rates.
The applicant must be the lead organization, or central
collaborating organization, for a community coalition of three (3) or
more organizations, focusing on minority health concerns. The lead
organization will serve as leader, catalyst, facilitator, and
coordinator. The lead organization must have direct fiduciary
responsibility over the administration and management of the project
and will distribute funds to other partners in the coalition as
appropriate.
The Racial and Ethnic Approaches to Community Health (REACH)
Demonstration Projects are two-phase projects whose purpose is for
communities to mobilize and organize their resources in support of
effective and sustainable programs which will eliminate the health
disparities of racial and ethnic minorities.
The REACH Demonstration Projects are a Department of Health and
Human Services initiative in response to the President's Initiative on
Race. The REACH Demonstration Projects will test science-based
community level interventions which could be effective in eliminating
health disparities, with the goal of replicating their successes in
other communities.
Phase I is a 12-month planning Phase to organize and prepare
infrastructure for Phase II. Cooperative agreements in Phase I will
support the planning and development of demonstration programs using a
collaborative multi-agency and community participation model. Phase I
may also include the collection of data necessary to develop baseline
measures for assessing the outcomes of the projects. Upon completion of
Phase I, grantees will have utilized appropriate data and developed a
Community Action Plan (CAP) designed to reduce the level of disparity
within the selected communities in one or more of the six priority
areas of complications of diabetes, deficits in breast and cervical
cancer screening and management, deficits in child and adult
immunizations, cardiovascular diseases, HIV, or infant mortality. The
CAP must target a specific racial or ethnic minority community that is
African American, American Indian or Alaska Native, Hispanic American,
Asian American, or Pacific Islander. Communities or groups which cannot
be specified under these categories will not be considered. Only
applicants selected for Phase I will be eligible to compete for
additional funds to implement and evaluate the demonstration program of
Phase II.
Phase II is the implementation of a demonstration project of
specified interventions for a specified priority areas(s), for a well
defined minority population. Phase Ii also involves appropriate
evaluations of interventions and outcomes of the project.
CDC is committed to achieving the health promotion and disease
prevention objectives of the Department of Health and Human Services'
Initiative to Eliminate Racial and Ethnic Health Disparities, Healthy
People 2000, and Healthy People 2010 a nationwide strategy to reduce
morbidity and mortality and improve the quality of life. This
announcement relates to the Healthy People 2000 and Healthy People 2010
priority areas of infant mortality, diabetes, cardiovascular diseases,
HIV, cancer screening and prevention, and immunizations specifically
pertaining to a racial or ethnic minority community that is African
American, American Indian, Alaska Native, Hispanic American, Asian
American, or Pacific Islander.
B. Eligible Applicants
Applications may be submitted by (a) private nonprofit
organizations (including community-based organizations and foundation),
(b) universities, colleges, research institutions, and hospitals, (c)
governments and their agencies (including State and local health
agencies, or their bona fide agents, and community health centers), and
(d) federally recognized Indian tribal governments, Indian tribes, or
Indian tribal organizations.
1. Organizational Eligibility Criteria
Eligible applicants must further be organizations active in
community-focused, collaborative efforts which serve to bring together
agencies, community groups, academic institutions and other groups to
address health or social concerns. These organizations will serve as
central collaborating bodies in a community collaboration.
2. Private and Non-Profit Organizations
Private and non-profit organizations must have the following
characteristics:
a. The applicant organization must be part of a collaborative
community health effort that is organized and has appropriate
experience as follows:
(i) A governing board composed of more than 50% racial or ethnic
minority members at the time of application or prior to Phase II, or
(ii) A significant number of minority individuals in key program
positions (including management, administrative, and service
provision), who reflect the racial and ethnic demographics, and the
characteristics of the population to be served.
In addition, private, nonprofit organizations which are affiliated
with a larger organization with a national board, must document that
the larger organization has the same board composition listed above.
3. Lead Organization
The applicant must be the lead organization, or Center Coordinating
Organization, for a community coalition focusing on minority health
concerns. The Central Coordinating Organization must have direct
fiduciary responsibility over the administration and management of the
project. All applicants must include proof of collaborative
relationships with a least three (3) other organizations as evidenced
by signed Memoranda of agreements (or other official documentation)
among the participants. The applicant must be able to show
representation by the minority community in the coalition.
4. Organizational Experience
The applicant must document at least 2 years of experience in
operating and centrally administering a coordinated public health or
related program serving racial or ethnic minority populations. Such
programs must have included:
a. The collection of appropriate program data (example of data
collected must be appended to the application);
b. the implementation of complex, community level intervention
strategies used in successful public health programs in such areas as
infant mortality, diabetes, cardiovascular diseases, HIV, deficits in
breast and cervical cancer screening and management, or deficits in
child or adult immunization rates (examples of programs implemented
must be appended to the application).
5. Tax-Exempt Status
For those applicants applying as a private, nonprofit organization,
proof of tax-exempt status must be provided with the application. Tax-
exempt status is determined by the Internal Revenue Service (IRS) Code,
Section 501(c)(3). Any of the following is acceptable evidence:
a. A reference to the organization's listing in the IRS's most
recent list of
[[Page 11917]]
tax-exempt organizations described in section 501(c)(3) of the IRS
Code.
b. A copy of a currently valid IRS tax-exemption certificate.
c. A statement from a state taxing body, State Attorney General, or
other appropriate state official certifying that the applicant
organization has a nonprofit status and that none of the net earnings
accrue to any private shareholders or individuals.
d. A certified copy of the organization's certificate of
incorporation or similar document if it clearly establishes the
nonprofit status of the organization.
Note: Public Law 104-65 states that an organization described in
section 501(c)(4) of the Internal Revenue Code of 1986 that engages
in lobbying activities is not eligible to receive Federal funds
constituting an award, grant, cooperative agreement, contract, loan,
or any other form.
C. Availability of Funds
In FY 1999, CDC expects to provide up to $9,400,000 for funding
approximately 30 Phase I cooperative agreements. It is expected that
the awards will begin on or about September 30, 1999 and will be made
for a 12-month budget period. Only Phase I recipients which
successfully compete for Phase II awards may anticipate and additional
four years of funding (for a total project period of five (5) years for
Phase I and Phase II). Funding estimates, and continuation of awards,
may change based on the availability of funds.
Approximately $30 million may be available to fund approximately
15-20 Phase II cooperative agreements. Criteria for selection of Phase
II grantees are:
1. Extent to which Phase I requirements were met.
2. Appropriate definition of the level of health disparity among
the target population and the extent of the disparity.
3. Potential for proposed interventions to affect the priority
area(s).
4. Extent of inclusion of community participants and partners.
Awardee will specifically be evaluated on their ability to recruit and
maintain appropriate community and public/private collaborators.
5. The potential for community action plans to assure
sustainability of the effort.
6. The potential for the community action plans to leverage
additional public and/or private resources to support the overall
prevention effort.
7. The appropriateness and thoroughness of the evaluation process
to assess the impact and effectiveness of the project intervention in
the community. (Standard performance measures to be provided in
addendum).
8. The appropriateness and thoroughness of the data collection
infrastructure that is planned for and developed for the demonstration
project.
Should additional funding become available in the future, a new
announcement will be issued and grantees funded under Phase I of this
announcement, but not funded for Phase II, will receive preference for
funding under the new announcement.
Use of Funds
Under this program announcement, funds may not be used for data
collection or research until Institutional Review Board (IRB) approval
is obtained. Funds may be restricted until appropriate IRB clearances
and procedures are in place.
Funds may not be used to support direct patient medical care, or
facilities construction in Phase I or Phase II, or to supplant or
duplicate existing funding.
Although applicants may contract with other organizations under
these cooperative agreements, applicants must perform a substantial
portion of the activities (including program management and operations)
for which funds are requested.
Funding Preferences
Geographic distribution among communities across the United States,
diversity in priority areas, and racial/ethnic diversity will be
funding considerations. Each applicant may submit only one application,
and only one award will be made per geographically-defined community. A
community will not be eligible for multiple awards for different
priority areas. However, applications addressing related priority areas
(e.g. diabetes and cardiovascular diseases, HIV and infant mortality,
etc.) will be considered.
D. Program Requirements
In conducting activities to achieve the purposes of this program,
the recipient will be responsible for the activities under 1. Recipient
Activities, and CDC will be responsible for the activities under 2. CDC
Activities.
1. Recipient Activities
(Phase I)
a. Select intervention strategies which have the most promising
potential for reducing the health disparities of the target population.
Develop a Community Action Plan reflecting the intervention strategies,
and other activities described in Recipient Activities, Phase II.
b. Coordinate and use relevant data and community input to assess
the extent of the problem in the selected program priority areas
(diabetes, deficits in breast and cervical cancer screening and
management, deficits in adult and child immunizations, cardiovascular
diseases, HIV or infant mortality).
c. Identify academic partners, foundations, and State and local
agencies, from which to strengthen the community's overall ability to
eliminate the health disparities of the target population, and to
demonstrate the changes in health disparities. Establish community
working groups to address critical program issues, and enhance local
partnerships to strengthen the overall commitment of the community.
Establish linkages with national and state partners (governmental and
non-governmental) and other interested organizations.
d. Identify data sources and establish outcome and process
evaluation measures to be reviewed at the completion of Phase I.
Collaborate with CDC, academic partners or other appropriate
organizations, to determine an appropriate evaluation of the program
and to identify promising intervention strategies for Phase II.
e. Participate in up to 3 CDC sponsored workshops for technical
assistance, planning, evaluation and other essential programmatic
issues.
(Phase II)
a. Implement the community action plan addressing the selected
priority area(s) for the target population. Initiate actions to assure
the interventions are provided appropriately and in a timely manner.
b. Collect appropriate data to monitor and evaluate the program
including process and outcome measures.
c. Collaborate with academic or other appropriate institutions in
the analysis and interpretation of the data.
d. Maintain linkages and collaborations with local partners, and
develop new linkages with state and national partners.
e. Establish mechanisms with foundations, and other public and/or
private groups to maintain financial support for the program at the
conclusion of federal support.
f. Participate in conferences and workshops to inform and educate
others regarding the experiences and lessons learned from the project,
and collaborate with appropriate partners to publish the results of the
project to the public health community.
[[Page 11918]]
2. CDC Activities
a. Provide consultation and technical assistance in the planning
and evaluation of program activities.
b. Provide up-to-date scientific information on the basic
epidemiology of the priority area(s), recommendations on promising
intervention strategies, and other pertinent data and information needs
for the specified priority area(s) including prevention measures and
program strategies.
c. Assist in the analysis of data and evaluation of program
progress.
d. Assist recipients in collaborating with State and local health
departments, community planning groups, foundations and other funding
institutions, and other potential partners.
e. Foster the transfer of successful prevention interventions and
programs models through convening meetings of grantees, workshops,
conference, and communications with project officers.
E. Application Content
Each applicant may submit only one application. Applicants should
use the information in the Program Requirements, Other Requirements,
and Evaluation Criteria sections to develop the application content.
Applications will be evaluated on the criteria listed, so it is
important to follow them in laying out the program plan. In developing
this plan, applicants must describe a community-based program within at
least one of the six following priority areas: (1) Infant mortality,
(2) diabetes, (3) cardiovascular diseases, (4) HIV, (5) deficits in
breast and cervical cancer screening and management, or (6) deficits in
child and adult immunizations, that specifically focus on a racial or
ethnic minority community that is African American, American Indian,
Alaska Native, Hispanic American, Asian American, or Pacific Islander.
The narrative should be no more than 30 double-spaced pages,
printed on one side, with one inch margins, and 12 point font. The
thirty pages does not include budget, appended pages, or items placed
in appended pages (resumes, agency descriptions, etc.). The narrative
should include:
1. Introduction
A brief summary of which ethnic or racial group the applicant will
target, the population size of both the ethnic or racial group and
total population of the catchment area of the applicant and its
partners, the geographic boundaries in which the applicant will operate
(append a legible map to the application) and the priority area(s)
chosen for the proposal.
2. Community, Need, and Priority Area(s)
A description of the specific community's health problem and need
for the priority area(s) for which the applicant will address. Any data
in support of the priority area(s) and which defines the degree of
disparity in terms of mortality or morbidity (or other measures
appropriate to the priority areas(s)). All sources of data and
information must be referenced.
3. Organizational Summary
A brief organizational summary including mission statement, history
of incorporation, and experience in community-based work. Relevant
supporting documents (including resumes and job descriptions of
participating staff) should be appended to the application, but should
not be included in this summary.
A brief history of the organization's experience in operating and
centrally administering a coordinated public health or related program
serving racial or ethnic minority populations (including program data
collection and interventions for one or more of six (6) priority
areas). Other collaborative ventures should be included with a
description of the both the nature and extent of the collaborations.
Signed Memoranda of Agreement (or other official documentation) of the
relevant collaboration should be appended to the document, but not
included in this section of the narrative. Tribal resolution(s) or
letter(s) of support from tribal chair(s) or president(s) should be
appended to this section of the document for those applicants applying
as a federally recognized tribe.
4. History and Experience in Working With Ethnic/Racial Groups
Succinctly describe past working efforts in minority communities.
Applicants should also explain their current relationship with the
target population. Any other related experience in which the applicant
was involved but not the lead organization, but which is specific to
the target population should also be included. Letters of support,
awards, newspaper articles, evaluation reports, and other forms of
recognition which validate statements and past efforts should be
appended to the application.
5. Community Action Plan
A description of plans for developing and organizing the planning
effort, to including who is or should partner in the effort, how
community participation will be obtained, how the applicant anticipates
enhancing the sustainability of the effort including improving linkages
with collaborators and other organizations to leverage more resources
(such as foundations, health departments, and other potentially
influential and beneficial groups), how the applicant will collect data
and information to track progress towards project goals of decreasing
disparities. Letters of support from agencies, institutions, and other
potential collaborators as well as any examples of previous planning
documents should be appended to the application.
6. Evaluation Plan
A description of the evaluation and monitoring process that the
applicant will use to track and measure progress in Phase I. The
evaluation plan should include time-specific objectives which account
for the major activities of the community action plan, the means of
tracking and measuring the collaborative work with coalition partners,
and any other relevant process measures. Timeliness, objectives, and
other supporting documentation should be included in the appendix for
this section.
7. Budget
Provide a line-item budget with a detailed, narrative justification
that is consistent with the purpose and objectives of this cooperative
agreement.
F. Submission and Deadline
Letter of Intent (LOI)
Organizations intending to apply must submit a non-binding letter
of intent to the address below. Your letter of intent should include
the following information:
1. Identify the project by name and announcement number (99064).
2. Identify the geographic location, health priority area(s), and
racial/ethnic group which the application will address.
3. Certification that you meet the applicable eligibility
requirements contained in Section B., ``Eligible Applicants.''
This letter is a prerequisite for application under this
announcement, but will not influence the review or funding decision
process. This process will enable CDC to plan more efficiently for the
processing and review of the applications.
The letter of intent must be submitted and received at the address
below on or before [14 days after the date of the publication of the
final R.A. in the Federal Register].
[[Page 11919]]
Send the letter to: Adrienne Brown, Grants Management Specialist,
Grants Management Branch, Procurement and Grants Office, Announcement
99064, Centers for Disease Control and Prevention (CDC), 2920
Brandywine Road, Room 3000, Atlanta, Georgia 30341-4146.
Application
Submit the original and five copies of PHS-398 (OMB Number 0925-
0001) (adhere to the instructions on the Errata Instruction Sheet for
PHS 398). Forms are in the application kit. Submit the application on
or before [DATE TO BE DETERMINED], to the business management contact
listed in Section J., ``Where to Obtain Additional Information.''
Deadline: Applications shall be considered as meeting the deadline
if they are either:
(a) Received on or before the deadline date; or
(b) Sent on or before the deadline with a legibly dated U.S. Postal
Service postmark or obtain a legibly dated receipt from a commercial
carrier or U.S. Postal Service. Private metered postmarks shall not be
acceptable as proof of timely mailing.
Late Applications
Applications which do not meet the criteria in (a) or (b) above are
considered late applications, will not be considered, and will be
returned to the applicant.
G. Evaluation Criteria (100 points)
Each application will be evaluated individually against the
following criteria by an independent review group appointed by CDC.
1. Background on Community and Priority Area(s): (25 Points)
The extent to which the applicant clearly defines the racial/ethnic
group, community, and priority area(s) to be addressed. The extent to
which the applicant uses data and other supporting evidence to document
the disparities within the group, and the appropriateness of the target
population sizes (see addendum--to be developed) for the priority
area(s) selected. The degree of the disparity between the target
population and the general population based on local data wherever
available, or from state or national level data which directly supports
the basis for the health disparity in the priority area(s) selected.
2. Organizational Summary: (20 Points)
Extent to which the applicant describes existing facilities and
staff (including resumes and job descriptions) appropriate for the
proposed activities. The extent to which the applicant describes the
history, nature, and extent of their community activities with
supporting documentation. The adequacy of proposed staffing and
collaborations with partners, particularly to meet the design and
evaluation needs of the project. Also describe the degree to which you
have met the CDC Policy requirements regarding the inclusion of women,
ethnic, and racial groups in the proposed research.
3. History and Experience in Working on Public Health Programs With
Ethnic/Racial Groups: (25 Points)
Extent to which the applicant documents their experience and
successes in operating and centrally administering a coordinated public
health or related program serving the target population for the
selected priority area(s) (including appended letters of support).
Extent of experience in other public health programs, and public health
research or related data collection.
A. Community Action Plan (CAP): (20 Points)
Extent to which the applicant demonstrates a thorough and
reasonable plan for the development of their CAP, including the
assurance of community participation in the CAP.
5. Evaluation Plan: (10 Points)
Extent to which the applicant presents a reasonable and thorough
evaluation plan for Phase I. Appropriateness of evaluation methods,
goals, objectives, and timeliness to the development of the community
action plan and the overall planning effort, and identification of data
and information sources needed to track progress toward the project's
objectives.
6. Budget (Not Scored)
Extent to which a line-item budget is presented, justified, and is
consistent with the purposes and objectives of the cooperative
agreement.
H. Other Requirements
Technical Reporting Requirements
Provide CDC with original plus two copies of:
1. Progress reports semiannually;
2. Financial status report, no more than 90 days after the end of
the budget period; and
3. Final financial and performance reports, no more than 90 days
after the end of the project period. Send all reports to the business
management contact listed in Section J., ``Where to Obtain Additional
Information.''
The following additional requirements are applicable to this
program. For a complete description of each, see Attachment I in the
application kit.
AR-1 Human Subjects Requirements
AR-2 Requirements for Inclusion of Women and Racial and Ethnic
Minorities in Research
AR-7 Executive Order 12372 Review
AR-8 Public Health System Reporting Requirements
AR-9 Paperwork Reduction Act Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2000
AR-12 Lobbying Restrictions
AR-14 Accounting System Requirements
AR-15 Proof of Non-Profit Status
I. Authority and Catalog of Federal Domestic Assitance (CFDA)
Number
This program is authorized under sections 301, 317(k)(2), and 1706
(e) of the Public Health Service Act, [42 U.S.C. section 247b(k)(2)],
as amended. The Catalog of Federal Domestic Assistance number is
93.206.
J. Where To Obtain Additional Information
To receive additional written information and to request an
application kit, call 1-888-GRANTS4 (1-888-472-6874). You will be asked
to leave your name and address and will be instructed to identify the
Program Announcement Number 99064.
If you have questions after reviewing the contents of all the
documents, business management technical assitance may be obtained
from: Adrienne Brown, Grants Management Specialist, Grants Management
Branch, Procurement and Grants Office, Announacement 99064, Centers for
Disease Control and Prevention (CDC), 2920 Brandywine Road, Room, 3000,
Atlanta, GA 30341-4146, Telephone: (770) 488-2755, E-mail: asm1@cdc.gov
For program technical assistance, contact: Letitia Presley-
Cantrell, Centers for Disease Control and Prevention (CDC), 4770 Buford
Hwy, NE, Mailstop K-30, Atlanta, Georgia 30341, Telephone (770) 488-
5426, ccdinfo@cdc.gov
Also see the CDC home page on the Internet: http://www.cdc.gov
[[Page 11920]]
Dated: March 4, 1999.
John L. Williams,
Director, Procurement and Grants Office, Centers for Disease Control
and Prevention (CDC).
[FR Doc. 99-5866 Filed 3-9-99; 8:45 am]
BILLING CODE 4163-18-M
