[Federal Register Volume 59, Number 56 (Wednesday, March 23, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-6692]


[[Page Unknown]]

[Federal Register: March 23, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
[PN 2202]
RIN 0905-ZA14

 

Healthy Start Initiative--Special Project Grants

AGENCY: Health Resources and Services Administration (HRSA), PHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the availability of fiscal year 1994 funds for an open 
competition for Healthy Start Initiative--Special Projects grants (HSI-
SP). The purpose of the HSI-SP is to expand the Healthy Start 
Initiative to include community-based programs that will significantly 
reduce infant mortality through the development and implementation of 
special targeted interventions. Competition is open to rural and urban 
community-based programs that are developing and implementing 
innovative strategies for the purpose of reducing infant mortality. 
Awards will be made by the Maternal and Child Health Bureau under the 
program authority of Section 301 of the Public Health Service Act. 
Funds for the HSI-SP Grants were appropriated under Public Law 103-112. 
Up to $4,000,000 is available for four projects at up to $1,000,000 per 
year, renewable for a second year, subject to funds availability.
    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 HSI-SP grant program will 
directly address the Healthy People 2000 objectives related to maternal 
and infant health, and especially health status objective 14.1, to 
reduce the infant mortality rate to no more than 7 per 1000 live 
births. 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 (Revised PHS form 5161-1, approved under 
OMB clearance number 0937-0189) and guidance for applicants must be 
obtained from, and applications submitted to: Grants Management Branch, 
Maternal and Child Health Bureau, HRSA, room 18-12, Parklawn Building, 
5600 Fishers Lane, Rockville, Maryland 20857, telephone 301 443-1440.
DATES: The application deadline date is May 23, 1994. 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 applications or those sent to an address other than 
specified in the ADDRESS section will be returned to the applicant.

FOR FURTHER INFORMATION contact: Requests for technical or programmatic 
information should be directed to Thurma McCann, M.D., M.P.H., 
Director, Division of Healthy Start, Maternal and Child Health Bureau, 
HRSA, 12300 Twinbrook Parkway, Suite 200, Rockville, Maryland 20852, 
telephone 301 443-0543. Requests for information concerning 
administration and business management issues should be directed to 
Jeanne Conley, Grants Management Specialist, at the address listed in 
the ADDRESS section above.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

    The specific goal of the Healthy Start Initiative--Special Projects 
is to significantly reduce in two years high infant mortality rates in 
rural or urban designated project areas through accelerated 
implemention of innovative strategies. Therefore, it is expected that 
the programs will incorporate the principles of innovation, community 
commitment, and personal responsibility and, in doing so, improve 
access to care. To accomplish this goal, prospective applicants must 
have an established consortium which has a minimum of two years 
experience with planning and implementation of infant mortality 
strategies, including an extensive public information campaign. In 
addition, applicants must have the capacity and willingness to develop 
a management information system to track project interventions and to 
participate in an extensive national evaluation with currently funded 
Healthy Start projects.
    Finally, Federal Healthy Start Initiative--Special Projects grant 
funds may only be used to supplement, and not to supplant or replace, 
either existing State or local funds, or State or local funds that 
would otherwise be made available to the project.

Eligible Project Areas

    Areas targeted under the Healthy Start Initiative--Special Projects 
are those in which infant mortality problems are most severe, resources 
can be concentrated, implementation is manageable, and progress can be 
measured. A project area is defined as one which is composed of one or 
more contiguous geographic areas or neighborhoods for which 
improvements have been planned and are being implemented with the 
principles of: Innovation, community commitment and involvement, 
increased access, service integration, and personal responsibility. 
Project areas must represent a reasonable and logical catchment area in 
which a consortium for delivering services is already operational, and 
for which infant mortality reduction strategies are already designed.
    To be eligible for funding under the HSI-SP, a project area must 
have at least 50 but no more than 200 infant deaths per year, and must 
have an average infant mortality rate of at least 14.5 deaths per 1000 
live births, from vital statistics data, for the 3-year period 1988-
1990. The minimum of fifty infant deaths per year is meant to assure 
selection of communities with a sufficient magnitude of the problem to 
justify concentrating resources to reduce infant mortality. The upper 
limit of 200 infant deaths per year is meant to assure projects of a 
manageable size. The eligibility thresholds are identical for urban and 
rural areas.

Eligible Applicants

    Eligible applicants are public or nonprofit private organizations, 
and tribal organizations, applying on behalf of an existing community-
based consortium. Applications must be approved by the chief elected 
official of the city or county in which the project area is located 
(or, if there is more than one such entity, the chief elected officials 
acting in concert), or by the tribal leadership of the tribe or tribal 
organization which has jurisdiction over the project area. No more than 
one application may be made for a given project area.
    The 15 entities that are currently receiving Healthy Start 
Initiative funds are not eligible for Special Project grants.

Review Criteria

    Applications for grants will be reviewed and evaluated according to 
the following criteria:
    1. Existence of an operational consortium that includes appropriate 
representation of project area providers and consumers.
    2. The effectiveness of the consortium's activities over the 
previous two years, as demonstrated by implemented strategies to reduce 
infant mortality.
    3. The extent to which the applicant's proposed activities appear 
feasible and likely to achieve the project's goals and objectives 
within the two year project period.
    4. Demonstrated ability to maximize and coordinate existing 
resources and acquire additional resources.
    5. Substantial involvement of the State and local Maternal and 
Child Health and other agencies.
    6. Demonstrated ability to effectively manage the project's fiscal 
resources.
    7. Demonstrated leadership capability in achieving project goals 
and objectives in the last two years.
    8. Reasonableness of the proposed budget.
    9. Other factors which the Secretary determines will increase the 
potential of the project to significantly reduce the rate of infant 
mortality in the project area.

Preference and Priorities

    Funding preference will be given to an approved applicant who: (1) 
Has an operational infant mortality initiative of at least two years 
duration; (2) has a strong established community-based consortium that 
has identified and begun to address local needs and priorities; and (3) 
has demonstrated the ability to generate private sector funding. Within 
any group of preferred applicants, priority will be given to applicants 
from States that do not already have a funded Healthy Start Initiative 
grant. Because of time constraints, public comments on the funding 
preference and the funding priority are not being solicited.

Allowable Costs

    The Health Resources and Services Administration will support 
reasonable and necessary costs of Healthy Start Initiative Special 
Project grants within the scope of approved activities. Allowable costs 
may include salaries, equipment and supplies, travel, contractual, 
consultants, and others, as well as indirect costs. 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 Requirement

    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, subpart C reporting requirements will apply. 
Financial reporting will be required in accordance with 45 CFR part 74, 
subpart H, with the exception of State and local governments, to which 
45 CFR 92.20 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, 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.

The OMB Catalog of Federal Domestic Assistance number is 93.926.

    Dated: March 1, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-6692 Filed 3-22-94; 8:45 am]
BILLING CODE 4160-15-P