[Federal Register Volume 64, Number 95 (Tuesday, May 18, 1999)]
[Notices]
[Pages 26977-26981]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-12532]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Program Announcement 99064]
Racial and Ethnic Approaches to Community Health 2010; (REACH
2010) Demonstration Projects; Notice of Availability of Funds
The President has committed the nation to an ambitious goal by the
year 2010 to eliminate disparities in health status experienced by
racial and ethnic minority populations in key areas while continuing
the progress we have achieved in improving the overall health of the
American people. In support of this effort, the Department of Health
and Human Services identified six priority areas in which racial and
ethnic minorities experience serious health disparities: Infant
Mortality, Deficits in Breast and Cervical Cancer Screening and
Management, Cardiovascular Diseases, Diabetes, Human Immunodeficiency
Virus(HIV)Infections/Acquired Immunodeficiency Syndrome(AIDS), and
Deficits in Child and/or Adult Immunizations. On behalf of the DHHS-
wide collaborative effort, the Centers for Disease Control and
Prevention (CDC) will coordinate and manage a major component of
activities to support this initiative; this component is composed of
community based demonstration projects to address the six identified
priority areas of health disparities.
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, a nationwide strategy to reduce morbidity and mortality
and improve the quality of life. This announcement relates to the
Healthy People 2000 focus areas of Maternal and Infant Health, Diabetes
and Chronic Disabling Conditions, Heart Disease and Stroke, HIV
Infection, Cancer, and Immunization and Infectious Diseases.
A. Purpose
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, HIV infection/AIDS, deficits in
breast and cervical cancer screening and management, or deficits in
child and/or adult immunization rates.
Note: There will be a video-conference Pre-Application Workshop
on Friday, May 28, 1999. For more information, contact Letitia
Presley-Cantrell at (770) 488-5426 or E-mail ccdinfo@cdc.gov
The Racial and Ethnic Approaches to Community Health 2010 (REACH
2010) 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. These demonstrations
require but are not limited to collaboration of experts in developing
and managing health promotion programs and experts in conducting
health-related research. Such collaboration is needed in order to
identify and/or develop successful community-based disease prevention
and health promotion models that can be replicated for the ultimate
goal of eliminating health disparities among racial and ethnic
minorities.
The REACH 2010 Demonstration Projects will examine 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 development of 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 infant
mortality, diabetes, cardiovascular diseases, HIV infection/AIDS,
deficits in breast and cervical cancer screening and management, or
deficits in child and/or adult immunization rates. Please note that
applications addressing related priority areas (e.g. diabetes and
cardiovascular diseases, HIV infection/AIDS and infant mortality) will
be considered.
Phase II is the implementation of a demonstration project of
specified interventions for specified priority area(s), for a well
defined minority population. Phase II also involves appropriate
evaluations of interventions and outcomes of the project.
B. Eligible Applicants
Applications may be submitted by public and private nonprofit
organizations and by governments and their agencies; that is,
universities, colleges, research institutions, hospitals, other public
and private nonprofit organizations, State and local governments or
their bona fide agents, federally recognized Indian tribal governments
as well as non-federally recognized tribes and other organizations that
qualify under the Indian Civil Rights Act, State Charter Tribes, Urban
Indian Health Programs, Indian Health Boards, and Inter-Tribal
Councils.
Minimal Requirements
1. Proposal
The Applicant must target one or more specific racial or ethnic
minority communities 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.
[[Page 26978]]
2. Lead organization (CCO)
The applicant must be the lead organization, or Central
Coordinating Organization (CCO), for a community coalition to focus on
minority health concerns. The applicant must have at least two years of
such relevant experience within the past four years. The CCO must have
direct fiduciary responsibility over the administration and management
of the project. All applicants must include proof of collaborative
relationships with at least three (3) other organizations (see
requirements for Coalition Membership below) as evidenced by a detailed
(delineating responsibilities and budgetary support) and signed
Memoranda of Agreements (or other official documentation) among the
participants. The rationale for selection of the lead organization
should be included.
3. Coalition Membership
Coalitions (including the CCO) must have at a minimum a community-
based organization and three other organizations, of which at least one
must be either:
a. local or state health department, or
b. university of research organization.
The applicant must be able to show strong representation by the
minority community in the coalition.
4. 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 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 approximately $9,400,000 for
funding approximately 30 Phase I cooperative agreements. It is expected
that the average award will be $250,000, with awards ranging from
$200,000 to $300,000. 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 applicants selected for Phase I will be eligible to compete
for additional funds to implement and evaluate the demonstration
program of Phase II. Phase I recipients which successfully compete for
Phase II awards may anticipate an 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.
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, grantees
funded under Phase I, but not funded for Phase II, will receive
preference for funding.
Use of Funds
Under this program announcement, funds may not be used for research
involving human subjects until Institutional Review Board (IRB)
approval is obtained. Funds may be restricted until appropriate IRB
clearances and procedures are in place.
Funds may be used for priority areas only. However, this does not
restrict the applicant from documenting the association of underlying
causes and relationship to priority areas.
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 our intent is
to fund one award per community; therefore, applicants from the same
geographic area are encouraged to collaborate. Applicants must describe
the geographic boundaries and make-up of the area for which it is
applying. 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
infection/AIDS and infant mortality) 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. Enhance community coalition by identifying all appropriate
additional partners, including community-based organizations, academic,
foundations, State and local health agencies, Indian Health Boards,
NRMOs, etc., 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. The applicant must be
able to show strong representation by the targeted minority community
in the coalition.
b. Establish community working groups to address critical program
[[Page 26979]]
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.
c. Coordinate and use relevant data and community input to assess
the extent of the problem in the selected program priority areas
(infant mortality, diabetes, cardiovascular diseases, HIV infection/
AIDS, deficits in breast and cervical cancer screening and management,
or deficits in child and/or adult immunization rates).
d. 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 proposed for Phase II.
e. Identify data sources and establish outcome and process
evaluation measures to be reviewed at the completion of Phase I.
(Examples of possible performance measures are provided in the
Addendum). 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.
f. 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 administered effectively, appropriately and in a
timely manner.
b. Collect appropriate data to monitor and evaluate the program
including process and outcome measures.
c. Maintain linkages and collaborations with local partners, and
develop new linkages with state and national partners.
d. Collaborate with academic or other appropriate institutions in
the analysis and interpretation of the data.
e. Establish mechanisms with 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.
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
program models through convening meetings of grantees, workshops,
conferences, 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 infection/AIDS, (5)
deficits in breast and cervical cancer screening and management, or (6)
deficits in child and/or adult immunizations, that specifically focus
on a geographically defined 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. One Page Abstract
Describe:
a. the Central Coordinating Organization (type of organization and
relevant experience);
b. membership in the coalition (types of organizations as specified
in ``Eligible Applicants'' Section;
c. target racial/ethnic minority population(s) to be served; and
d. health priority area(s) to be addressed.
2. Introduction
A brief summary of which geographically defined racial or ethnic
group or groups the applicant will target, the population size of both
the ethnic or racial group(s) 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. The
enclosed Addendum includes a table that provides sample sizes that
could be needed to demonstrate a statistically significant intervention
effect. Based on this table, it has been calculated that a minimum of
3000 persons with the disease or health priority condition per
community will be necessary to find statistically significant results.
Since many of the communities may have considerably smaller sample
sizes, for the purpose of this announcement, a target population size
of 3000 is desirable but not mandatory. Applicants are encouraged to
include as large a population as possible in order to find
statistically significant results once an intervention is selected.
3. 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 area(s). All sources of data and
information must be referenced.
4. Organizational Summary (CCO and Coalition Members)
A brief organizational summary of the CCO 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 CCO's experience in operating and centrally
administering a coordinated public health or related program serving
the proposed and geographically defined racial or ethnic minority
populations (including program data collection and interventions for
one or more of the six (6) priority areas). Applicant must have at
least two years of such relevant
[[Page 26980]]
experience within the past four years. Applicants should describe the
extent to which racial and ethnic minorities are represented on
governing boards and in key leadership positions. Applicants should
provide descriptions of two years of other collaborative ventures
within the past four years and document: (a) the accomplishments of
those collaborative ventures, and (b) the characteristics that led to
the accomplishments. Applicant must describe nature of coalition and
members of coalition by type of organization and relevant
organizational experience. The applicant must be able to show strong
representation by the targeted minority community in the coalition.
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 tribes.
5. History and experience in working with ethnic/racial groups
Succinctly describe your experience working directly with the
target population for at least two years in the selected communities
during the past four years. 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.
6. Community Action Plan
A description of plans for developing and organizing the planning
effort, to include 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.
7. 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. Time lines, objectives, and
other supporting documentation should be included in the appendix for
this section.
8. Budget
Provide a line-item budget with a detailed, narrative justification
that is consistent with the purpose and objectives of this cooperative
agreement.
9. Human Subjects
Adequately address the requirements of Title 45 CFR Part 46 for the
protection of human subjects.
F. Submission and Deadline
Letter of Intent (LOI) Organizations intending to apply are
encouraged to 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. Identify Central Coordinating Organization (CCO) and Coalition
Members.
This process will enable CDC to plan more efficiently for the
processing and review of the applications.
Please submit the letter of intent to the address below on or
before June 1, 1999.
Send the letter to: Adrienne S. 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,
or
E-mail: asm1@cdc.gov
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 June 30, 1999, 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)
a. The extent to which the applicant clearly defines the racial/
ethnic group(s), geographic community, and priority area(s) to be
addressed.
b. The extent to which the applicant uses data if such data are
available and other supporting evidence to document the disparities
within the group, and the appropriateness of the target population
sizes (see addendum) for the priority area(s) selected. The enclosed
Addendum includes a table that provides sample sizes that could be
needed to demonstrate a statistically significant intervention effect.
Based on this table, it has been calculated that a minimum of 3000
persons with the disease or health priority condition per community
will be necessary to find statistically significant results. Since many
of the communities may have considerably smaller sample sizes, for the
purpose of this announcement, a target population size of 3000 is
desirable but not mandatory. Applicants are encouraged to include as
large a population as possible in order to find statistically
significant results once an intervention is selected.
c. 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
[[Page 26981]]
data which directly supports the basis for the health disparity in the
priority area(s) selected.
2. Organizational Summary: (20 Points)
a. Extent to which applicant describes the history, nature, and
extent of its relevant experience in organizing community activities
and details at least two years of relevant experience within that past
four years with supporting documentation.
b. Extent to which the applicant describes existing facilities and
staff (including resumes and job descriptions) to accomplish the
desired outcomes of Phase I.
c. The adequacy of proposed staffing and collaborations with
partners, particularly to meet the design and evaluation needs of the
project. Include the nature of coalition and members of coalition by
type of organization and relevant organizational experience. The
applicant must show strong representation by the minority community in
the coalition.
3. History and Experience in working on public health programs with
Ethnic/Racial Groups: (25 Points)
a. Extent to which the applicant documents its experience and
successes in operating and centrally administering a coordinated public
health or related program serving the target population for at least
two years (within the past four years) for the selected priority
area(s) (including appended letters of support).
b. Extent of experience in other public health programs, and public
health research or related data collection.
4. 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 and participation of coalition
members in the planning of the CAP.
5. Evaluation plan: (10 points)
a. Extent to which the applicant presents a reasonable and thorough
evaluation plan for Phase I.
b. Appropriateness of evaluation methods, goals, objectives, and
time lines 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.
7. Human Subjects (Not Scored)
Does the application include a plan to adequately address the
requirements of Title 45 CFR Part 46 for the protection of human
subjects?
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 status 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-4 HIV/AIDS Confidentiality Provisions
AR-5 HIV Program Review Panel Requirements
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 Assistance (CFDA)
Number
This program is authorized under sections 301(a) and 317(k)(2) of
the Public Health Service Act [42 U.S.C. 241(a)and 247b(k)(2)], as
amended. The Catalog of Federal Domestic Assistance number is 93.945.
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 assistance may be obtained
from: Adrienne S. 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, GA 30341-4146, Telephone: (770) 488-2755, E-mail:
asm1@cdc.gov
For this and other CDC announcements, see the CDC home page on the
Internet: http://www.cdc.gov
For program technical assistance, contact: Letitia Presley-
Cantrell, Centers for Disease Control and Prevention (CDC), National
Center for Chronic Disease Prevention and Health Promotion (NCCDPHP),
4770 Buford Hwy, NE, Mailstop K-30, Atlanta, Georgia 30341, Telephone:
(770) 488-5426, E-mail: ccdinfo@cdc.gov
Dated: May 12, 1999.
Henry S. Cassell,
Acting Director, Procurement and Grants Office, Centers for Disease
Control and Prevention (CDC).
[FR Doc. 99-12532 Filed 5-17-99; 8:45 am]
BILLING CODE 4163-18-P
