[Federal Register Volume 61, Number 43 (Monday, March 4, 1996)]
[Notices]
[Pages 8292-8297]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-4860]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Emergency Medical Services for Children Demonstration Grants
AGENCY: Health Resources and Services Administration HHS.
ACTION: Notice of availability of funds.
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SUMMARY: The HRSA in collaboration with the National Highway Traffic
Safety Administration (NHTSA) announces that applications will be
accepted for fiscal year (FY) 1996 funds for grants authorized under
section 1910 of the PHS Act. These discretionary grants will be made to
States or accredited schools of medicine to support projects for the
expansion and improvement of emergency medical services for children
(EMSC). Within the HRSA, EMSC grants are administered by the Maternal
and Child Health Bureau (MCHB).
This program announcement is subject to the appropriation of funds.
Applicants are advised that this program announcement is a contingency
action being taken to assure that should funds become available for
this purpose, they can be awarded in a timely fashion consistent with
the needs of the program as well as to provide for even distribution of
funds throughout the fiscal year. At this time, given a continuing
resolution and the absence of FY 1996 appropriations for the EMSC
program, the amount of available funding for this specific grant
program cannot be estimated.
The NHTSA participated with the MCHB in developing program
priorities for the EMSC program for FY 1996. The NHTSA will share the
Federal monitoring responsibilities for EMSC awards made during FY 1996
and will continue to provide ongoing technical assistance and
consultation in regard to the required collaboration/linkages between
applicants and their Highway Safety Offices and Emergency Medical
Services Agencies for the State(s). Grantees funded under this program
are expected to work collaboratively with the State agency or agencies
administering the Maternal and Child Health (MCH) and the Children with
Special Health Needs (CSHN) programs under the MCH Services Block
Grant, Title V of the Social Security Act (42 U.S.C. 701).
[[Page 8293]]
The PHS is committed to achieving the health promotion and disease
prevention objectives of Healthy People 2000, a PHS led national
activity for setting priority areas. The EMSC grant program will
directly address the Healthy People 2000 objectives related to
emergency medical services and trauma systems linking prehospital,
hospital, and rehabilitation services in order to prevent trauma deaths
and long-term disability. Potential applicants may obtain a copy of
Healthy People 2000 (Full Report: Stock No. 017-001-00474-0) or Healthy
People 2000 (Summary Report: Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
D.C. 20402-9325 (telephone, (202) 783-3238).
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.
In addition, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any portion
of a facility) in which regular or routine education, library, day
care, health care or early childhood development services are provided
to children.
ADDRESSES: Grant applications for Emergency Medical Services for
Children Demonstration Grants (Revised PHS form #5161-1, approved under
OMB #0937-0189) must be obtained from and submitted to: Grants
Management Branch, Maternal and Child Health Bureau, HRSA, Room 18-12,
Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, Attn:
EMSC, telephone 301-443-1440. You must obtain application materials in
the mail.
Federal Register notices and application guidance for MCHB programs
are available on the World Wide Web via the Internet at address: http:/
/www.os.dhhs.gov/hrsa/mchb. Click on the file name you want to download
to your computer. It will be saved as a self-extracting (Macintosh or)
Wordperfect 5.1 file. To decompress the file once it is downloaded,
type in the file name followed by a . The file will expand to a
Wordperfect 5.1 file. If you have difficulty accessing the MCHB Home
Page via the Internet and need technical assistance, please contact
Linda L. Schneider at 301-443-0767 or lschneider@hrsa.ssw.dhhs.gov''.
DATES: The application deadline date is April 26, 1996. Competing
applications will be considered to be on time if they are either
received on or before the deadline date or postmarked on or before the
deadline date and received in time for orderly processing. Applicants
should request a legibly dated receipt from a commercial carrier or the
U.S. Postal Service, or obtain a legibly dated U.S. Postal Service
postmark. Private metered postmarks will not be accepted as proof of
timely mailing.
Late competing applications or those sent to an address other than
specified in the ADDRESSES section will be returned to the applicant.
FOR FURTHER INFORMATION CONTACT: Requests for technical or programmatic
information from MCHB should be directed to Jean Athey, Ph.D., or Mark
E. Nehring, D.M.D., M.P.H., Division of Maternal, Infant, Child and
Adolescent Health, Maternal and Child Health Bureau, Health Resources
and Services Administration, Room 18A-39, Parklawn Building, 5600
Fishers Lane, Rockville, Maryland 20857, telephone (301) 443-4026.
Requests for technical or programmatic information from NHTSA should be
directed to Garry Criddle, R.N., CDR, USCG/USPHS, Department of
Transportation, NHTSA EMS Division, NTS-42, 400 Seventh Street SW.,
Washington, DC 20590, telephone (202) 366-5440. Requests for
information concerning business management issues should be directed
to: Maria Carter, Grants Management Specialist, Grants Management
Branch, Maternal and Child Health Bureau, at the address listed in the
ADDRESS section above.
The EMSC program funds three national EMSC resource centers that
are available to provide technical assistance and support to
applicants, particularly in the areas of: (1) understanding EMSC
terminology; (2) developing a manageable approach to EMSC
implementation; (3) obtaining local support for the grant application
process; (4) facilitating development of community linkages for a
collaborative effort; (5) identifying products of previously-funded
EMSC projects of interest to potential applicants; (6) offering advice
on grant writing; and (7) data collection and analysis. Applicants may
contact: James Seidel, M.D., Ph.D., or Deborah Henderson, R.N., M.A.,
National EMSC Resource Alliance, Research and Education Institute,
Harbor/UCLA Medical Center, 1001 West Carson Street, Suite S, Torrance,
CA 90502, telephone 310 328-0720; or Jane Ball, R.N., Dr. P.H., EMSC
National Resource Center, Children's National Medical Center, Emergency
Trauma Services, 111 Michigan Ave., N.W., Washington, DC 20010,
telephone 202 745-5188; or J. Michael Dean, M.D., National EMSC Data
Analysis Resource Center, University of Utah School of Medicine, 309
Park Building, Salt Lake City, UT 84112, telephone (801) 588-2360.
SUPPLEMENTARY INFORMATION:
Program Background and Objectives
The Emergency Medical Services for Children statute (Section 1910
of the PHS Act, as amended) establishes a program of two-year grants to
States, through a State-designated agency, or to accredited medical
schools within States, for projects for the expansion and improvement
of emergency medical services for children who need treatment for
trauma or critical illness. For purposes of this grant program, the
term ``State'' includes the 50 States, the District of Columbia, the
Commonwealth of Puerto Rico, the Virgin Islands, the Northern Mariana
Islands, Guam, American Samoa, the Republic of Palau, the Republic of
the Marshall Islands, and the Federated States of Micronesia. The term
``school of medicine'' is defined as having the same meaning as set
forth in Section 799(1)(A) of the PHS Act (42 U.S.C. 295p(1)(A)).
``Accredited'' in this context has the same meaning as set forth in
section 799(1)(E) of the PHS Act (42 U.S.C. 295p(1)(E)). It is the
intent of this grant program to stimulate further development or
expansion of ongoing efforts in the States to reduce the problems of
life-threatening pediatric trauma and critical illness. The Department
does not intend to award grants which would duplicate grants previously
funded under the Emergency Medical Services Systems Act of 1972 or
which would be used simply to increase the availability of emergency
medical services funds allotted to the State under the Preventive
Health Services Block Grant.
Funding Categories
There will be three categories of competition for funding this
year: State planning grants, State systems grants, and targeted issue
grants. States may apply for only one of the first two categories, but
are not restricted in applying for the last category.
Category (1): State Planning Grants
Planning grants are intended for States that have never received an
EMSC grant and that are not at a stage of readiness to initiate a full-
scale implementation project. States (or medical schools within those
States) that have not received prior EMSC implementation grants are the
only applicants eligible for this category. Planning grants are
designed to enable a State to assess needs and develop a strategy to
begin to address those needs.
[[Page 8294]]
Funds may be used to hire staff to assist in the assessment of EMSC
needs of the State; obtain technical assistance from national, State,
regional or local resources; help formulate a State plan for the
integration of EMSC services into the existing State EMS plan; and plan
a more comprehensive grant proposal based upon a needs assessment
performed during the planning grant project period. A comprehensive
approach, addressing physical, psychological, and social aspects of
EMSC along the continuum of care, should be reflected. An ongoing
working relationship with Federal EMSC program staff and resource
center staff, beginning with the initiation of a planning grant
application, is desirable. The project period is for one year only.
Category (2): State Systems Grants
This category of grants has two subcategories: implementation
grants and system enhancement grants. For both subcategories, proposals
are sought which include strategies and/or models to ensure that
pediatric emergency care is family centered. ``Family centered''
includes the following key elements: maximum possible involvement of
families in all phases of the EMSC continuum of care; clear and
continuous communication between family members and the emergency care
team; attention to the psychological needs of all family members;
cultural competence of providers; consumer (parental) involvement in
planning and needs assessment; organizational support for the formation
of parent involvement groups; and ongoing partnerships with such
groups.
Applications will not be accepted for both planning grants and
state systems grants simultaneously from the same State.
Subcategory (A): Implementation Grants
Implementation grants will improve the capacity of a State's
Emergency Medical Services program to address the particular needs of
children. Implementation grants are used to assist States in
integrating research-based knowledge and state-of-the-art systems
development approaches into the existing State EMS, MCH and CSHN
systems, using the experience and products of previous EMSC grantees.
The program components of these grants should reflect the goals of the
MCHB/NHTSA Five Year Plan for EMSC. This plan outlines the direction of
the EMSC program and identifies specific objectives for the program. It
builds on the 1993 report for EMSC conducted by a blue ribbon Institute
of Medicine panel. The plan will be included with the application kit.
Depending upon the appropriation of funds, project periods are up to
two years. For this competition, we intend to fund applications from
States (and medical schools within those States) that have not as yet
received support, or that have received only partial support under this
program as part of a regional alliance. This means that approved
applications from States (and medical schools within those States) with
no or very limited prior EMSC program support will be funded before
approved applications from outside this group.
Subcategory (B): System Enhancement Grants
System enhancement grants will fund activities that represent the
next logical step or steps to take in institutionalizing EMSC
activities within the State EMS, MCH and CSHN systems and achieving
program goals outlined in this announcement. The program components of
these grants should reflect the goals and objectives of the MCHB/NHTSA
Five Year Plan for EMSC. For example, funding might be used to improve
linkages between local and regional or State agencies, to develop
pediatric standards for a region, or to assure effective field triage
of the child in physical or emotional crisis to appropriate facilities
and/or other resources. Activities implemented under prior EMSC program
funding but not completed or made self-sustaining during the original
implementation project period will not be considered suitable. States
that have previously received EMSC funds may apply for a system
enhancement grant, as long as they will not also be receiving
continuation funding for a State implementation grant during the
project period of the systems enhancement grant.
Category (3): Targeted Issues Grants
The third funding category is that of targeted issues grants on
topics of importance to EMSC. Targeted issues grants are intended to
address specific, focused issues related to the development of EMSC
capacity. Proposals under this category must have a well-conceived
methodology for evaluation of the impact of the activity. The EMSC Five
Year Plan identifies several activities judged to be appropriate for
support through targeted issues grants for FY 1996. They include the
following:
1. Cost-Benefit Analyses Related to EMSC
Very limited information is available on the costs related to
different aspects of EMSC, and yet such information is critical to
decision making. Projects in this category may include topics such as
the following:
Analyses of the impact of insurance, managed care, and
Federal and/or State health care financing policies and protocols on
pediatric emergency medical services.
Analyses of the impact of differing reimbursement policies
in contiguous jurisdictions on pediatric patients.
Assessment of the marginal incremental cost of different
approaches to improving EMSC.
Evaluation of the cost-effectiveness of different EMSC
program configurations (such as different approaches to medical
control, categorization, and regionalization).
2. Risk-Taking Behaviors of Children and Adolescents
Emergency department health professionals are uniquely positioned
to provide interventions to reduce the incidence of repeated episodes
when treating a child or adolescent for an injury or medical condition
(e.g., noncompliant child or adolescent with a chronic condition, such
as diabetes) resulting from risk-taking behavior. Projects in this
category can be directed to development and evaluation of materials and
strategies for emergency departments in one or more of the following
areas:
Unintentional injury prevention.
Violence or suicide prevention.
Integration of mental health services with preventive
interventions (injury or medical).
3. Care of Children With Special Health Needs (CSHN)
An organized system of emergency care is needed for children who
have special health care needs (children who are respirator dependent,
children with tracheostomies, indwelling (broviac) catheters, gastric
tubes, etc.) on discharge from acute care settings. Projects in this
category can be directed to one or more of the following:
Development, implementation and evaluation of educational
or training programs for families.
Development, implementation, and evaluation of educational
or training programs for health care providers (e.g., prehospital,
emergency department, school nurses. etc.).
Evaluation of models for comprehensive discharge planning.
Development and evaluation of model injury prevention
programs for CSHN.
Projects in this category must demonstrate collaboration and
linkages
[[Page 8295]]
among EMS and CSHN agencies, as well as families and other agencies and
organizations, as appropriate (e.g., schools).
4. EMSC-Related Models for Improving the Care of Culturally Diverse
Populations
In emergencies, health care providers are often required to meet
the needs of linguistically, culturally and ethnically diverse children
and families, but little training is provided in this area. Projects in
this category can be directed to one or more of the following:
Development, implementation and evaluation of education
and training programs in cultural sensitivity for prehospital
providers, nurses, and physicians.
Development (or translation), implementation, and
evaluation of discharge, injury prevention and health care materials
for low literacy populations and for culturally and/or ethnically
diverse populations.
Projects in this category must demonstrate collaboration and
linkages among EMS or MCH agencies, acute care facilities, and
ethnically-oriented community organizations and agencies to assure
sensitivity to ethnic and cultural issues.
5. Children's Emergencies in Disasters
Local, regional, and State disaster plans typically do not address
the training and equipment necessary to meet the special needs of
children in disasters. Projects in this category should address one or
more of the seven recommendations identified in the September 21-22,
1995, Workshop on Children's Emergencies in Disasters, co-sponsored by
the Maternal and Child Health Bureau, the Federal Emergency Management
Agency, and the Substance Abuse and Mental Health Services
Administration (a copy of these recommendations is included in the
application kit). Examples of projects appropriate for this category
include the following:
Development of a strategy to integrate pediatrics into
existing disaster plans, in particular focusing on the following
components: Training, equipment, psychosocial support, system access
and cost reimbursement, shelter services, and mitigation.
Identification of key data to be collected, collection,
and analysis of data on children's health and mental health needs in
disasters.
Proposals may be submitted on emerging issues that are not included
in the above list. However, any such proposal must demonstrate
relevance to the EMSC Five Year Plan and must make a persuasive
argument that the issue is particularly critical. The justification
provided should clearly link the activities in the application with the
Plan's objectives. Current targeted issues grantees may apply for one
additional year of funding.
Prospective applicants are urged to contact EMSC program staff well
in advance of submitting their formal applications, so that the work of
proposal development can be avoided if the proposed project is
inappropriate for submission in this category.
Special Concerns
HRSA's Maternal and Child Health Bureau places special emphasis on
improving service delivery to women, children and youth from
communities with limited access to comprehensive care. In order to
assure access and cultural competence, it is expected that projects
will involve individuals from the populations to be served in the
planning and implementation of the project. The Bureau's intent is to
ensure that project interventions are responsive to the cultural and
linguistic needs of special populations, that services are accessible
to consumers, and that the broadest possible representation of
culturally distinct and historically underrepresented groups is
supported through programs and projects sponsored by the MCHB. This
same special emphasis applies to improving service delivery to children
with special health care needs.
In keeping with the goals of advancing the development of human
potential, strengthening the Nation's capacity to provide high quality
education by broadening participation in MCHB programs of institutions
that may have perspectives uniquely reflecting the Nation's cultural
and linguistic diversity, and increasing opportunities for all
Americans to participate in and benefit from Federal public health
programs, HRSA will place a funding priority on projects from
Historically Black Colleges and Universities (HBCU) or Hispanic Serving
Institutions (HSI) in all categories and subcategories in this notice
for which applications from academic institutions are encouraged. This
is in conformity with the Federal Government's policies in support of
White House Initiatives on Historically Black Colleges and Universities
(Executive Order 12876) and Educational Excellence for Hispanic
Americans (Executive Order 12900). An approved proposal from a HBCU or
HSI will receive a 0.5 point favorable adjustment of the priority score
in a 4 point range before funding decisions are made.
Evaluation Protocol
A maternal and child health discretionary grant project, including
any project awarded as part of the Emergency Medical Services for
Children Demonstration Grants program, is expected to incorporate a
carefully designed and well planned evaluation protocol capable of
demonstrating and documenting measurable progress toward achieving the
project's stated goals. The protocol should be based on a clear
rationale relating the grant activities, the project goals, and the
evaluation measures. Wherever possible, the measurements of progress
toward goals should focus on health outcome indicators, rather than on
intermediate measures such as process or outputs. A project lacking a
complete and well-conceived evaluation protocol as part of the planned
activities will not be funded.
Public Comment
If time permits, comments from the public will be accepted on the
categories, priorities, and preferences described in this notice.
Public comments received too late for consideration this year will be
considered in the development of program categories, priorities, or
preferences for FY 1997. Members of the public should submit any
comments to: Chief, Grants Management Branch, MCHB, at the address
listed in the ADDRESS section.
Project Review and Funding
The Department will review applications in the preceding funding
categories as competing applications and will fund those which, in the
Department's view, are consistent with the statutory purpose of the
program, with particular attention to children from culturally distinct
populations and children with special health care needs; and that best
meet the purposes of the EMSC program and address achievement of
applicable Healthy People 2000 objectives related to emergency medical
services and trauma systems.
Review Criteria
The review of applications will take into consideration the
following criteria:
For Category (1) State Planning Grants:
--Evidence of the State's commitment to improve pediatric emergency
care services and to continue with EMSC program implementation.
[[Page 8296]]
--The adequacy of the applicant's proposed method to identify problems
and conduct a needs assessment.
--Evidence of the applicant's understanding of obstacles to EMSC
activity in the past, and the completeness of proposed strategies to
overcome these obstacles.
--The adequacy of the applicant's proposed planning process for
improving EMSC.
--The soundness of the methods the applicant will use to: (1) recruit,
select and assemble appropriate participants, including members of
culturally distinct populations, with demonstrated expertise and
experience in EMS; trauma systems; child health issues; and emergency
care for children; and (2) obtain input from potential consumers (i.e.,
families) of a State EMSC plan.
--Reasonableness of the proposed budget, soundness of the arrangements
for fiscal management, effectiveness of use of personnel, and
likelihood of project completion within the proposed grant period.
For Categories (2) and (3) State Systems and Targeted
Issues Grants:
--The appropriateness of project objectives and outcomes in relation to
the specific nature of the problems identified by the applicant.
--The adequacy of the proposed methodology for achieving project goals
and objectives.
--The soundness of the plan for evaluating progress in achieving
project objectives and outcomes.
--The adequacy of the plan for organizing and carrying out the project.
--The qualifications and experience of the Project Director and
proposed staff.
--The reasonableness of the proposed budget and soundness of the
arrangements for fiscal management.
--The extent to which the project gives special emphasis to the issues
identified in the Special Concerns section of this notice.
For Category (2) State Systems Grants only, the following
additional criteria:
--The adequacy of the applicant's understanding of the problem of
pediatric trauma and critical illness in the grant locale, including
the special problems of (a) children with special health needs (CSHN)
and their families; and (b) minority children and families (including
Native Americans, Native Hawaiians, and Alaska Natives).
--The extent to which the applicant will employ products and expertise
of EMSC programs from other States, especially of current and former
grantees of the Federal EMSC program.
--The adequacy with which the applicant addresses institutionalization
of the proposed project.
--The extent to which the applicant demonstrates the involvement and
participation of consumers (e.g., families) and parent advocacy groups
in planning, needs assessment, and project implementation.
--The extent to which the applicant demonstrates a multi-disciplinary
approach to EMSC system development, including providers at all levels
(e.g., physicians, nurses, emergency medical technicians, social
workers and others appropriate to project activities).
--Evidence that the applicant will collaborate and coordinate with
other participants in the EMSC continuum, e.g., the State EMS agency;
the State MCH/CSHN agency; the State Highway Safety Office; other
relevant State agencies; tribal nations; state and local professional
organizations; private sector voluntary organizations; business
organizations; hospital organizations; and any other ongoing Federally-
funded projects in EMS, injury prevention, and rural health.
--The adequacy of the applicant's plan to integrate pediatric emergency
care into the primary care delivery system.
For Category (3) Targeted Issues Grants only, the following
additional criteria:
--The relevance of the proposed project to the MCHB/NHTSA Five Year
Plan for EMSC.
Eligible Applicants
No more than one grant under this program will be made in any State
(to a State or a school of medicine in the State) in any fiscal year.
Applications for funding will be accepted from States and accredited
schools of medicine. Applications which involve more than a single
State will also be accepted. In developing the proposed project,
applicants must seek the participation and support of local or regional
trauma centers and other interested entities within the State, such as
local government and health and medical organizations in the private
sector. If the applicant is a school of medicine, the application must
be endorsed by the State. The State's endorsement must acknowledge that
the applicant has consulted with the State and that the State has been
assured that the applicant will work with the State on the proposed
project.
Any State (or medical school within that State) may apply for any
category or subcategory of grant, subject to the following
considerations based on equitable geographic distribution of EMSC
funds, differences in purpose among EMSC grant categories, and
variation among States in EMSC program progress:
For Category (1) Planning Grants, States (or medical
schools within those States) that have received prior EMSC state
systems grants may not apply for a planning grant.
For Category (2)(A) Implementation Grants, applications
from States (and medical schools within those States) that have not
previously received EMSC program funds, or that have received only
partial support under this program as part of a regional alliance, will
receive preference for funding in this subcategory. This means that
approved applications from States (and medical schools within those
States) with no or very limited prior EMSC program support will be
funded ahead of approved applications from outside this group.
For Category (2)(B) System Enhancement Grants, States (and
medical schools within those States) that have previously received EMSC
funds may apply for a system enhancement grant, as long as they will
not also be receiving implementation funds during the project period of
the system enhancement grant. States that have not previously received
EMSC funds are advised to apply first for implementation category
funds.
For Category (3) Targeted Issues Grants, eligibility is
not affected by previous receipt of other EMSC funding. Applications
will not be considered for both Category (1) State Planning Grants and
Category (2) State Systems Grants simultaneously from the same State.
Funding of an application for a planning grant or for a Category (2)(A)
implementation grant bars a State from future competitions for that
category or subcategory.
Allowable Costs
The HRSA may support reasonable and necessary costs of EMSC
Demonstration Grant projects within the scope of approved projects.
Allowable costs may include salaries, equipment and supplies, travel,
contracts, consultants, and others, as well as indirect costs as
negotiated and certified. The HRSA adheres to administrative standards
reflected in the Code of Federal Regulations, 45 CFR Part 92 and 45 CFR
Part 74.
[[Page 8297]]
Public Health System Reporting Requirements
This program is subject to the Public Health System Reporting
Requirements (approved under OMB No. 0937-0195). Under these
requirements, community-based nongovernmental applicants must prepare
and submit a Public Health System Impact Statement (PHSIS). The PHSIS
is intended to provide information to State and local health officials
to keep them apprised of proposed health services grant applications
submitted by community-based nongovernmental organizations within their
jurisdictions. Community-based non-governmental applicants are required
to submit the following information to the head of the appropriate
State and local health agencies in the area(s) to be impacted no later
than the Federal application receipt due date:
(a) A copy of the face page of the application (SF 424).
(b) A summary of the project (PHSIS), not to exceed one page, which
provides:
(1) A description of the population to be served.
(2) A summary of the services to be provided.
(3) A description of the coordination planned with the appropriate
State or local health agencies.
The project abstract may be used in lieu of the one-page PHSIS, if
the applicant is required to submit a PHSIS.
Executive Order 12372
This program has been determined to be a program which is subject
to the provisions of Executive Order 12372 concerning intergovernmental
review of Federal programs by appropriate health planning agencies, as
implemented by 45 CFR Part 100. Executive Order 12372 allows States the
option of setting up a system for reviewing applications from within
their States for assistance under certain Federal programs. The
application packages to be made available under this notice will
contain a listing of States which have chosen to set up such a review
system and will provide a single point of contact (SPOC) in the States
for review. Applicants (other than federally-recognized Indian tribal
governments) should contact their State SPOCs as early as possible to
alert them to the prospective applications and receive any necessary
instructions on the State process. For proposed projects serving more
than one State, the applicant is advised to contact the SPOC of each
affected State. The due date for State process recommendations is 60
days after the application deadline for new and competing awards. The
granting agency does not guarantee to ``accommodate or explain'' for
State process recommendations it receives after that date. (See Part
148, Intergovernmental Review of PHS Programs under Executive Order
12372 and 45 CFR Part 100 for a description of the review process and
requirements).
The OMB Catalog of Federal Domestic Assistance number is 93.127.
Dated: February 27, 1996.
Ciro V. Sumaya,
Administrator.
[FR Doc. 96-4860 Filed 3-1-96; 8:45 am]
BILLING CODE 4160-15-P
