[Federal Register Volume 61, Number 45 (Wednesday, March 6, 1996)]
[Notices]
[Pages 8962-8965]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-5209]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Ryan White Title IV Grants for Coordinated HIV Services and
Access to Research for Children, Youth, Women, and Families
AGENCY: Health Resources and Services Administration (HRSA), PHS.
ACTION: Notice of availability of funds.
-----------------------------------------------------------------------
SUMMARY: The HRSA announces that applications will be accepted for
fiscal year (FY) 1996 funds for grants for projects that enhance access
to clinical research trials and other research, and develop and support
the provision of coordinated comprehensive services and activities for
children, youth, women and families infected/affected by the Human
Immunodeficiency Virus (HIV). Projects will be funded to implement
programs of family-centered, community-based coordinated care and
research for children, youth, women, and families infected/affected by
HIV, or those at risk for developing infection. These projects are
authorized under, and expected to meet provisions contained within,
Section 2671 of the Public Health Service Act [as enacted by Title IV,
of the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act of
1990, Public Law 101-381 (42 U.S.C. 300ff-11 et seq.)]. Within the
HRSA, Ryan White Title IV projects 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. In addition, reauthorization of the Ryan
White CARE Act, currently pending in Congress, could add new Title IV
grant requirements in addition to those included in this notice.
The PHS is committed to achieving the health promotion and disease
prevention objectives of Healthy People 2000, a PHS national activity
for setting priority areas. Title IV directly addresses the Healthy
People 2000 objectives related to the priority area of HIV infection.
Potential applicants may obtain a copy of Healthy People 2000 (Full
Report; Stock Number 017-001-0474-0) or Healthy People 2000 (Summary
Report: Stock No. 017-001-00473-1) through the Superintendent of
Documents, Government Printing Office, Washington, DC 20402-9325
(telephone 202 783-3238).
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and to 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 routine education, library, day
care, child care or early development services are provided to
children.
ADDRESSES: Grant applications for the Ryan White Title IV Program (PHS
form #5161-1, approved under OMB #0937-0189) must be obtained from and
submitted to: Mona D. Thompson, Grants Management Branch, Office of
Program Support, Maternal and Child Health Bureau, HRSA, Room 18-12,
Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, (301)
443-3429. 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 19, 1996. Competing
applications will be considered to be on time if they are:
(1) Received on or before the deadline date, or
(2) Postmarked on or before deadline date and received in time for
orderly processing.
As proof of timely mailing, applicants should obtain a legibly
dated receipt from the commercial carrier or the U.S. Postal Service;
private metered postmarks will not be accepted as proof of timely
mailing.
Late applications not accepted for processing or those sent to an
address other than specified in the ADDRESSES section will be returned
to the applicant.
FOR FURTHER INFORMATION CONTACT:
Additional information regarding technical and program issues may be
obtained from: the Division of Services for Children with Special
Health Needs, Maternal and Child Health Bureau, Health Resources and
Services Administration, Room 18A-19, Parklawn Building, 5600 Fishers
Lane, Rockville, Maryland 20857, Telephone (301) 443-9051. Requests for
information concerning business management issues should be directed
to: Sandra Perry, Acting Grants Management Officer (GMO), Maternal and
Child Health Bureau, at the address specified in the ADDRESSES section.
SUPPLEMENTARY INFORMATION:
Program Background and Objectives
The Pediatric AIDS Program was initiated in 1988. The program grew
from 13 projects funded at $4.4 million to a total of 59 projects
funded at $25.4 million in FY 1995. Since 1988, the program has evolved
from a primary focus on the coordination of services for the management
and care of infected children and their families to also address the
broader prevention and care needs of youth and women infected/affected
by HIV. In FY 1994, Congress funded the Pediatric AIDS Program under
section 2671, Title IV of the Ryan White Comprehensive AIDS Resources
Emergency (CARE) Act 1990, Public Law 101-381 (Title IV). As a result
of
[[Page 8963]]
authorization under Title IV, the focus of the program was expanded to
include the development of innovative models linking clinical trials
offered by the National Institutes of Health (NIH) and other research
entities, with systems of comprehensive primary/community-based medical
and social services.
In 1994 published results from a NIH clinical trial (ACTG 076)
demonstrated the potential for reducing perinatal HIV transmission by
two-thirds when pregnant women and their newborns were given zidovidine
(ZDV). The ZDV therapy regimen has been published in the Centers for
Disease Control's Morbidity and Mortality Weekly Report (MMWR 1994:43
(RR-11).
Over the past year, the CDC has issued recommendations for enhanced
voluntary HIV counseling and testing for women of child bearing age,
and the HRSA issued an Advisory: The Use of Zidovidine (ZDV) to reduce
Perinatal HIV Transmission in HRSA-Funded Programs. This advisory
contains practical, specific steps for implementing U.S. Public Health
Services recommendations for offering zidovidine (ZDV) to pregnant
women. A copy of this advisory will be mailed to all Title IV
applicants with the application guidance. Applicants are expected to
review this advisory and describe how they will implement these
recommendations in their application.
Reauthorization of the Ryan White CARE Act is pending in Congress.
The final version of the Act, which will include Title IV, is expected
to contain new requirements concerning arrangements between Title IV
programs and research entities and enhancement of opportunities for
Title IV Clients to participate in clinical research. Reauthorization
of the Ryan White CARE Act could result in incorporation of additional
requirements for Title IV grants in the applications guidance for these
projects.
Purpose
The purpose of Title IV funding is to link clinical research and
other research activities with comprehensive care systems, and to
improve and expand the coordination of a system of comprehensive care
for children, youth, women, and families who are infected/affected by
HIV. Funds will be used to support programs that: (1) cross established
systems of care to coordinate service delivery, HIV prevention efforts,
and clinical research and other research activities; and (2) address
the barriers to comprehensive care and research experienced by
children, youth, women, and families infected/affected by HIV.
While children, youth, and women represent the most recently
impacted and rapidly growing population groups affected by HIV, they
also represent the groups facing the greatest barriers in accessing
care and research. These groups are disproportionately members of
communities of color with limited economic resources. Given these
realities, children, youth, and women affected by HIV are confronted
with a complex array of economic and social issues that increase their
need for comprehensive services and increase the cost and intensity of
care. Existing systems of care are often not prepared to respond to
these needs and require targeted resources and interventions in order
to develop infrastructures and provider capacities that would allow
them to provide quality care to these populations.
Given these unmet needs, activities under these grants should
address the following goals:
--Link HIV/AIDS clinical research trials and other research activities
with comprehensive systems of care, resulting in increased access for
children, youth, women, and their families.
--Foster the development and support of comprehensive care
infrastructures, including primary care, that increase access to
culturally-competent, family-centered, community-based, coordinated
care.
--Emphasize prevention within the comprehensive care system in order to
reduce the spread of the HIV infection to vulnerable populations.
Funding Category
Applications which do not fall within this program category will
not be considered for funding.
The Ryan White Title IV Program for Children, Youth, Women, and
Families develops and supports innovative projects that foster
collaboration between clinical research institutions and family-
centered, primary/community-based medical and social service programs,
and that coordinate systems of comprehensive HIV care for children,
youth, women and their families. Projects will focus on local capacity-
building, making maximum use of all available public and private
resources for reaching and providing health care and supportive
services to the target population. Projects should strengthen existing
comprehensive care infrastructures by: (1) broadening the coalition of
agencies, providers, community organizations and consumers that
participate in the identification of needs, services planning, the
coordination and delivery of services, and the financing of services
for HIV affected populations; and (2) identifying and addressing
systemic issues that affect provider collaboration and impact the
provision of coordinated high quality comprehensive care.
Preference for funding in this category will be given to projects
that have: (1) established and currently support a comprehensive,
coordinated, system of HIV care serving either children, youth, women,
or families; and (2) linked with, or initiated activities to link with
clinical trials or other research. This means that these projects will
be funded ahead of new groups of applications in this category.
Special Concerns
Grantees supported by Title IV of the Ryan White CARE Act should
coordinate their projects with other Federal, State, and local programs
concerned with HIV and/or serving the target population of children,
youth, women and families affected by or at risk for HIV, particularly:
Title V Maternal ad Child Health programs; Ryan White Titles I, II and
III(b) programs; providers funded by the Substance Abuse and Mental
Health Services Administration; the Health Resources and Services
Administration; the Centers for Disease Control prevention efforts; and
clinical trials funded by NIH or other sources.
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.
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
[[Page 8964]]
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.
Applications will be reviewed with particular attention to
inclusion of women and persons from culturally distinct populations.
Funding will be provided to those which, in the Department's view, best
meet the statutory purposes of the Ryan White Title IV Program and
address achievement of the Health People 2000 objectives related to HIV
infection.
Review Criteria
Applications for grant categories will be reviewed and rated by
objective review panels according to the following weighted criteria:
1. Documentation of the HIV medical and social support service
needs of children, youth, women and families. Weight: 15 percent.
2. Demonstration of capacity to coordinate and support a
comprehensive system of HIV care for children, youth, women and
families. Weight: 25 percent.
3. Demonstrated capacity to provide clinical trials or to establish
linkages with providers offering clinical trials, or other research.
Weight: 15 percent.
4. The degree to which the Title IV's program priority of consumer
involvement has been implemented. Weight: 10 percent.
5. The degree to which the proposed plan:
Addresses the issues identified in response to Review
Criteria I;
Reflects the legislative and programmatic priorities of
the Title IV program (access to clinical trials, reduction of perinatal
HIV transmission, and consumer involvement);
Contains goals and objectives that are clear, measurable,
and time framed; and
Presents an evaluation strategy capable of documenting the
achievement of project goals. Weight: 25 percent.
6. The degree to which the proposed budget clearly supports
administrative and programmatic activities necessary to manage the
program and accomplish proposed goals and activities. Weight: 10
percent.
Eligible Applicants
Grants may be awarded to public or nonprofit private entities that
provide or arrange for primary health care. Eligible entities may
include, but are not limited to, State or local health departments,
university medical centers, public or nonprofit private hospitals,
community health centers (as defined in section 330(a) of the Act),
hemophilia treatment centers, drug abuse treatment agencies, tribal
health programs, school based clinics and institutions of higher
education.
If any additional eligibility requirements are established in a
reauthorized Ryan White CARE Act, they will be clearly identified in
the application guidance.
Allowable Costs
The HRSA may support reasonable and necessary costs of HIV Project
grants within the scope of approved projects. Allowable costs may
include salaries, equipment and supplies, travel, contractual
arrangements, consultants, and others, as well as indirect costs. The
HRSA adheres to administrative standards reflected in the Code of
Federal Regulations (45 CFR Part 92 and 45 CFR Part 74). All other
sources of funding to support this project must be accurately reflected
in the applicant's budget.
Reporting Requirements
A successful applicant under this notice will submit reports in
accordance with the provisions of the general regulations which apply
under 45 CFR Part 74, Subpart J, Monitoring and Reporting of Program
Performance, with the exception of State and local governments to which
45 CFR Part 92.40 will apply. Financial reporting will be required in
accordance with 45 CFR Part 74, Subpart I, with the exception of State
and local governments, to which 45 CFR Subpart C will apply.
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, the community-based nongovernmental applicant 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 nongovernmental 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 5161).
(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 and 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
The Title IV Program has been determined to be 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 (Form PHS 5161-1 with revised face
sheet HHS Form 424 and with Program Narrative and Checklist approved
under OMB 0937-0189) 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'' State process
recommendations it receives after that date. (See Part 148,
Intergovernmental Review of PHS Programs under Executive Order 12372
and 45 CFR part
[[Page 8965]]
100 for a description of the review process and requirements.)
(The OMB Catalog of Federal Domestic Assistance number for the HIV
Program for Children, Youth, Women, and Families is 93.153)
Dated: February 29, 1996.
Ciro V. Sumaya,
Administrator.
[FR Doc. 96-5209 Filed 3-5-96; 8:45 am]
BILLING CODE 4160-15-M
