[Federal Register Volume 59, Number 33 (Thursday, February 17, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-3601]


[[Page Unknown]]

[Federal Register: February 17, 1994]


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FEDERAL RESERVE SYSTEM
[PN 2164]

 

Emergency Medical Services for Children Demonstration Grants

AGENCY: Health Resources and Services Administration (HRSA), PHS, 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 the availability of fiscal year 
(FY) 1994 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). Funds 
appropriated by Public Law 103-112 will be used for this purpose. Under 
the EMSC program authority, awards are made for project periods of up 
to 2 years.
    The NHTSA participated with the HRSA in developing program 
priorities for the EMSC program for FY 1994. The NHTSA will share the 
Federal monitoring responsibilities for EMSC awards made during FY 1994 
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 trauma systems 
planning and development projects funded by the Bureau of Health 
Resources Development, HRSA.
    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, DC 
20402-9325 (telephone 202 783-3238).

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.

DATES: The application deadline date is May 6, 1994, for all categories 
except planning grants, which are due March 25, 1994. These are 
different from the dates announced in the Federal Register on February 
2, 1994 (59 FR 4925). Competing applications will be considered to be 
on time if they are either:
    (1) Received on or before the deadline date, or
    (2) 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 ADDRESS section will be returned to the applicant.

FOR FURTHER INFORMATION: Requests for technical or programmatic 
information should be directed to Jean Athey, Ph.D., 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 7th 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 ADDRESSES section above.
    In addition, this program funds two 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; and (6) offering 
advice on grant writing. 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., NW., Washington, DC 20010, telephone 202 745-5188.

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 an accredited medical 
school within the State, 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 four categories of competition for funding this year: 
State planning grants, State systems grants, targeted issue grants, and 
resource capacity grants. States may apply for only one of the first 
two categories, but are not restricted in applying for the last two 
categories.
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. 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 strongly encouraged. Budget 
requests in this category should not exceed $50,000, The project period 
is for one year only, with no renewal. Applications in this category 
are due earlier than other categories. The application deadline is 
March 25, 1994.
Category (2): State Systems Grants
    This category of grants has two subcategories: implementation 
grants and system enhancement grants. Proposals for State systems 
grants may be framed within the context of the changing conditions of 
health care delivery anticipated under health care reform.
    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/trauma systems using the experience and products of previous EMSC 
grantees. Grants of up to $250,000 per award for each twelve month 
budget period are anticipated. Project periods are up to two years. Up 
to five grants will be awarded. 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. 
Applications will not be accepted for both planning grants and 
implementation grants simultaneously from the same State.
    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 system and achieving program goals outlined in this announcement 
and further elaborated in the 1993 Institute of Medicine Report to 
Congress entitled Emergency Medical Services for Children. (A copy of 
the Executive Summary of this report will be enclosed with the 
application kit. The full report is available for $49.95 from National 
Academy Press, 2101 Constitution Avenue, NW., Box 285, Washington, DC 
20055.) 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 
implementation grant funds during the project period of the systems 
enhancement grant. Grants of up to $150,000 are anticipated for the 
first year, with grants of up to $100,000 for the second year.
Category (3): Targeted Issues Grants
    The third funding category is that of targeted issues grants on 
topics of importance to EMSC. These grants are intended to address 
specific, focused issues related to the development of EMSC capacity, 
with the potential to serve as national or regional models. Proposals 
in this category must have a well conceived methodology to evaluate the 
impact of the activity. The Director of the Maternal and Child Health 
Bureau (MCHB) will judge the acceptability of projects proposed in this 
category. 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 judged to be inappropriate for submission in this category.
    Priorities for this category have been chosen from topics 
recommended by the 1993 Institute of Medicine Report on EMSC. 
Priorities and examples include:

--Education and Training. For this priority, proposals are sought 
which develop or evaluate education or training geared to improving 
EMS providers' ability to address underdeveloped elements in EMSC. 
They may relate to particular areas of attention, such as the 
psychosocial aspects of EMSC, or to particular populations that are 
underserved or isolated. Proposals focusing on underserved or 
isolated populations of children might target the needs of Native 
Americans, Native Alaskans, or Native Hawaiians, adolescents, 
developmentally disabled, mentally ill, homeless, or children living 
in rural areas or inner cities. Educational programs might also be 
developed for particular groups, such as parents, volunteers, 
caretakers, teachers, firefighters, medical control or medical 
dispatch personnel. Assessment of the effectiveness of the training, 
using appropriate outcome measures, is a key objective for proposals 
in this category. Proposals are expected to incorporate existing 
materials whenever possible; however, innovations in media or 
instructional techniques are encouraged. Projects could include the 
conversion of previously developed teaching materials to interactive 
video format, the development of curricula or training exercises to 
promote improved EMS management of psychosocial crises, or the 
utilization of multidisciplinary seminars or study groups to enhance 
collaboration on pediatric emergency care between primary and 
specialty providers.
--Data and Information System Management. For this priority, 
proposals are sought which reflect an understanding of the uses to 
which data are to be applied (e.g., patient care, quality 
assessment, resource allocation, research, etc.) and of the 
questions they are to answer. Projects should reflect familiarity 
with efforts of NHTSA, HRSA, the Centers for Disease Control and 
Prevention (CDC), and the EMSC program to develop national uniform 
data sets, if appropriate to the proposed project. States are 
encouraged to develop EMS data systems which include all the 
elements of a national uniform data set and are capable of 
describing the nature of EMS provided to children. Demonstrations of 
linkage of data sources to provide an optimal picture of EMS 
furnished to children is one example of a proposed project under 
this priority; such proposals would be expected to show considerable 
familiarity with previous linkage efforts by the above organizations 
and others. Another example is the improvement of the quality of 
data that relate mechanisms of injury to assigned E-codes.
--Communications. For this priority, proposals are sought which take 
advantage of new telecommunications technologies to improve EMS for 
children. Proposals could promote access to ``911'' or ``enhanced 
911'' emergency telephone systems. For example, projects might use 
the ``Make the Right Call'' campaign on a statewide basis, with 
modifications that include educating the public--including 
children--about when to access EMS services for children; such 
projects would be expected to incorporate a well conceived 
evaluation of the impact of such a campaign. Alternatively, 
proposals could promote the use of advanced technologies to improve 
care for children. For example, projects might use new technology to 
improve communications among health care facilities, linking 
hospitals, health care agencies and/or providers; or to educate 
various categories of providers by providing on-line pediatric 
medical control via new technology. Proposals are also sought which 
evaluate, describe, analyze, or improve the pattern of EMS 
communications, dispatcher protocols, or on-line medical control as 
they affect the care of children or in relationship to pediatric 
utilization of emergency medical services. This priority has been 
developed in cooperation with HRSA's Trauma Care Systems Planning 
and Development Program.
--Violence and Injury Prevention. For this priority, activities 
could include advocacy, education, training, or curriculum 
development, especially in the development of programs which expand 
the role of EMS personnel in prevention of injury, interpersonal 
violence, or youth-on-youth violence. Innovative strategies to link 
EMS personnel with law enforcement personnel, primary care 
providers, and community resources are sought. Examples are programs 
to reduce children's access to firearms or to educate children about 
the use of seatbelts or bicycle helmets. Further examples include 
the use of EMS personnel as trainer/educators, advocates, and 
organizers for community based violence prevention initiatives in 
schools and other settings serving youth, such as recreation 
centers, detention centers, or youth employment centers; or the use 
of EMS records to study the characteristics of violence or for 
education about the consequences of violence. Violence and injury 
prevention initiatives might also focus on enhancing preparation of 
EMS personnel for providing initial attention and arranging 
appropriate follow-up when there are violent, destructive, damaging, 
or hurtful behaviors, or when there are injury-risking behaviors, 
such as combined drinking and driving, substance abuse, or attempted 
suicide by intentional overdosing on drugs.
--Psychosocial/Behavioral. Proposals are sought for this priority 
focusing on strategies to reduce the emotional toll of childhood 
emergencies on the child, family, and/or providers. Examples include 
development and evaluation of techniques to increase the sensitivity 
of EMS personnel to psychosocial issues affecting children, 
adolescents, and their families and enhance EMS provider skills, 
knowledge, and crisis intervention capability in dealing with these 
issues; development and evaluation of approaches and techniques for 
assisting EMS personnel in dealing with child and family crises 
arising from abuse, neglect, sexual assault, or noncompliant and 
other high risk behaviors; or activities that foster greater synergy 
between primary care and mental health specialty personnel in 
dealing with psychosocial aspects of EMSC.
    Up to five grants will be awarded in Category (3), at least one 
in each priority area, if approved. States that have received EMSC 
funding as well as those that have never received EMSC funding may 
compete in this category. Grants for this activity of up to $150,000 
per award for each twelve month budget period are anticipated. 
Project periods are up to two years.
Category (4): Resource Capacity Cooperative Agreements
    Up to two resource centers will be supported through cooperative 
agreements under this funding category. One of these will include 
maintenance and distribution of EMSC products among its activities and 
will receive more funds than the other. Resource centers are intended 
to provide assistance to the public, professional groups, and grantees 
on issues of importance in developing an EMSC system. In addition to 
monitoring and technical assistance, Federal involvement will include 
the following:

--Making available the services of experienced MCHB personnel as 
participants in the planning and development of all phases of the 
project.
--Participation, as appropriate, in any conferences and meetings 
conducted during the period of the cooperative agreement.
--Review, approval, and implementation of procedures to be 
established for accomplishing the scope of work.
--Assistance and referral in the establishment of Federal 
interagency contacts that may be needed to carry out the project and 
assisting MCHB dissemination and program communication goals.
--Participation in the dissemination of project products.

    If time permits, comments from the public will be accepted on the 
categories, priorities, and preferences described above. Any comments 
which members of the public wish to make should be submitted to: Chief, 
Grants Management Branch, at the address listed in the ADDRESSES 
section.

Availability of Funds

    Approximately $7,500,000 is available for grants under the EMSC 
program, of which approximately $3,600,000 will be used for new grants. 
Of this total, the distribution of funds for new grants is anticipated 
to be as follows: 

------------------------------------------------------------------------
                               Maximum                         Project  
         Category             number of   Estimated amounts     period  
                               awards*       available*        (years)  
------------------------------------------------------------------------
(1) State Planning.........            4           $200,000            1
(2) State Systems:                                                      
    (A) Implementation.....            5          1,250,000            2
    (B) System Enhancement.            4            600,000            2
(3) Targeted Issues........            5            750,000            2
(4) Resource Capacity......            2            800,000           2 
------------------------------------------------------------------------
*All grant amounts in this notice include indirect costs.               

Special Concerns

    The MCHB places special emphasis on improving service delivery to 
children from culturally identifiable populations who have been 
disproportionately affected by barriers to accessible care. This means 
that EMSC projects are expected to serve and appropriately involve in 
project activities members of ethnoculturally distinct groups, unless 
there are compelling programmatic or other justifications for not doing 
so. The MCHB's intent is to ensure that project outcomes are of benefit 
to culturally distinct populations and to ensure 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.

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.
--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 
minorities, with demonstrated expertise and experience in EMS; 
trauma systems; child health issues; and emergency care for 
children; and (2) obtain input from potential consumers 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 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 care needs 
(CSHCN) and their families; and (b) minority children and families 
(including Native Americans, Native Hawaiians, and Alaska Natives).
--The appropriateness of project objectives and outcomes in relation 
to the specific nature of the problems identified by the applicant.
--In relation to the state of the art, the soundness, 
appropriateness, comprehensiveness, cost effectiveness, and 
responsiveness of the proposed methodology for achieving project 
goals and outcome objectives.
--The soundness of the plan for evaluating progress in achieving 
project objectives and outcomes.
--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.
--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 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 extent to which the applicant can ensure institutionalization 
of the proposed project.
--The extent to which the applicant demonstrates collaboration and 
coordination with any trauma care systems implementation plan funded 
by HRSA.
--Evidence that the applicant will: (1) Collaborate and coordinate 
with other participants in the EMSC continuum, e.g., the State 
Emergency Medical Services agency; the State MCH/CSHCN agency; the 
State Highway Safety Office; other relevant State agencies, such as 
mental health; tribal nations; state and local professional 
organizations; private sector voluntary organizations; business 
organizations; parent advocacy groups; consumer or community 
representatives; hospital organizations; and any other ongoing 
federally funded projects in EMS, injury prevention, and rural 
health;
--Evidence that the applicant will integrate EMSC systems into the 
primary care delivery system.

 For Category (4) Resource Capacity Cooperative Agreements

--The adequacy of the applicant's understanding of the problem of 
pediatric trauma and critical illness, including the special 
problems of (a) CSHCN and their families; and (b) minority children 
and families (including Native Americans, Native Hawaiians, and 
Alaska Natives). This understanding includes knowledge of and 
experience with strategies to overcome identified problems as well 
as knowledge of and experience with the Title V MCH Block Grant.
--The appropriateness of project objectives and outcomes in relation 
to the specific nature of the problems identified by the applicant.
--The soundness, appropriateness, comprehensiveness, cost 
effectiveness and responsiveness of the proposed methodology for 
achieving project goals and outcome objectives.
--The extent to which the proposed resources are necessary and 
sufficient for project activities.
--The soundness of the plan for evaluating progress in achieving 
project objectives and outcomes.
--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.
--The extent to which the applicant is capable of successfully 
carrying out the project, particularly, the qualifications of 
proposed staff.
--The extent to which the applicant will employ products and 
expertise of EMSC programs, especially those of current and former 
EMSC program grantees.
--The extent to which the project gives special emphasis to the 
issues identified in the Special Concerns section of this notice.
--The likelihood of success of the applicant's proposed strategies 
for promoting coordination and collaboration between separate 
centers providing different resource capacities.

Eligible Applicants

    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 
implementation grants may not apply for planning grants.
     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 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 
systems 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 receipt of other EMSC funding.
     For Category (4) Resource Capacity Cooperative Agreements, 
eligibility is not affected by receipt of other EMSC funding.
    Applications will not be considered for both Category (1) State 
Planning Grants and Category (2)(A) Implementation Grants 
simultaneously from the same State. Funding of an application for a 
planning grant or for either subcategory of State Systems Grant bars a 
State from future competitions for that category or subcategory. 
Although funding of a Category (3) Targeted Issue Grant does not 
preclude a State (or medical school) from applying for other categories 
of EMSC funding, applicants should taken care to avoid overlap in 
proposed project activities and associated Federal support for the 
separate categories.

Allowable Costs

    The MCHB 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 MCHB adheres to administrative standards 
reflected in the Code of Federal Regulations, 45 CFR part 92 and 45 CFR 
part 74.

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.

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: December 14, 1993.
John H. Kelso,
Acting Administrator.
[FR Doc. 94-3601 Filed 2-16-94; 8:45 am]
BILLING CODE 4160-15-P