[Federal Register Volume 59, Number 98 (Monday, May 23, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-12550]


[[Page Unknown]]

[Federal Register: May 23, 1994]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

 

Availability of Funds for Grants for the Public Housing Primary 
Care Program and for a Minority Community Health Coalition 
Demonstration Program Related to HIV/AIDS Centered Education and 
Prevention

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of available funds.

-----------------------------------------------------------------------

SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the availability of approximately $8.7 million in 
discretionary grants for noncompeting continuation and competing grants 
for fiscal year (FY) 1994. The funds will be awarded under Section 340A 
of the Public Health Service (PHS) Act, as amended, 42 U.S.C. 256a.
    The purpose of these grants is to provide primary health services, 
as defined in section 330(b)(1) of the PHS Act, including health 
screenings, and health counseling and education services to residents 
of public housing.
    In addition, approximately $500,000 will be available in FY 1994 
for a demonstration effort co-sponsored by the Health Resources and 
Services Administration (HRSA) and the Office of Minority Health (OMH), 
located in the Office of the Assistant Secretary for Health. This 
activity will assist in implementing section 1707(d)(1) of the PHS Act 
and will enable public housing grantees to organize and operate 
Minority Community Health Coalitions (MCHC) and to implement HIV/AIDS 
health education and prevention strategies.
    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. This program announcement is 
related to the priority area of improving access to health services for 
minorities and disadvantaged Americans in underserved areas. 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). 
The Public Health Service strongly encourages all grant recipients to 
provide a smoke-free workplace and promote the non-use of all tobacco 
products. This is consistent with the PHS mission to protect and 
advance the physical and mental health of the American people.

ADDRESSES: The PHS Regional Grants Management Officers (RGMO), whose 
names and addresses are provided in the appendix to this document, are 
responsible for distributing program application and guidance 
instructions (Form PHS 5161-1, revised 07/92, with revised face sheet 
HHS Form 424, as approved by the Office of Management and Budget under 
control number 0937-0189), and completed applications must be submitted 
to them. The RGMO can also provide assistance on business management 
issues.

DUE DATES: All applications are due to the appropriate RGMO June 22, 
1994, except the Whittier Street Health Center of Roxbury, MA, whose 
due date is May 1, 1994, and was so notified directly. 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 U.S. Postal Service postmark or obtain a 
legibly-dated receipt from a commercial carrier or the U.S. Postal 
Service. Private metered postmarks will not be acceptable as proof of 
timely mailing. Late applications will not be considered for funding 
and will be returned to the applicant.

FOR FURTHER INFORMATION CONTACT: For general program information and 
technical assistance, contact Ms. Joan Holloway, Director, or Mr. James 
Gray, Chief, Health Care for the Homeless Branch, Division of Programs 
for Special Populations, Bureau of Primary Health Care, at 4350 East-
West Highway, Bethesda, Maryland 20814 (telephone 301-594-4420 or 594-
4430, respectively).

SUPPLEMENTARY INFORMATION:

I. Public Housing Primary Care Program

    Approximately $8.7 million is available for awards. It is 
anticipated that the above funds will be awarded to support up to 7 
noncompeting continuation grants ranging from $217,667 to $375,000, and 
up to 14 competing grants, ranging from $125,000 to $775,000 each for a 
project period of up to three years.

Eligible Entities

    To be eligible, an applicant must be a public or nonprofit private 
entity and have the capacity to effectively administer this grant 
program. In an area where there are a certified Resident Management 
Corporation (RMC) and public or private nonprofit entities providing 
primary health services, including those receiving funds under sections 
330 or 340 of the PHS Act, the organizations are encouraged to submit 
only one application demonstrating collaboration between the respective 
organizations.

Applicable Requirements

    Grantees providing primary health services directly and 
organizations with whom grantees contract to provide primary health 
services must be participating and qualified providers under the 
Medicaid plan approved under Title XIX of the Social Security Act, and 
must maximize payment for services available from private insurance, 
Medicare, other Federal programs, and other third-party sources. 
Grantees entering into contracts for services may be granted a waiver 
of this requirement if the organization they contract with does not 
impose a charge or accept payment available from any third-party payor, 
including payment under any insurance policy or under any Federal or 
State health benefits program, including Medicaid.
    The Secretary may not make a grant to an applicant unless the 
applicant signs an agreement indicating that, whether the services are 
provided directly or through contract, services under the grant will be 
provided without regard to ability to pay for the services. Further, if 
a charge is imposed, it will: (1) be made according to a schedule of 
charges that is made available to the public; (2) not be imposed on any 
resident of public housing with an income less than the official 
poverty level; and (3) be adjusted to reflect the income and resources 
of the resident.
    For applicants which are public entities (e.g., State or local 
health departments or institutions of higher education) the Secretary 
may not award a grant unless the public entity agrees that, with 
respect to the costs to be incurred by such entity in carrying out the 
purposes of the grant, the entity will make available non-Federal 
contributions in cash toward such costs in an amount equal to $1.00 for 
each $1.00 of Federal funds. In-kind contributions will not constitute 
acceptable contributions. Also, funds provided by the Federal 
Government, or services assisted or subsidized by the Federal 
Government, may not be included in determining the amount of the non-
Federal contributions.

Project Requirements

    The following services are required by Section 340A and must be 
provided either directly or through contract:
    (1) Primary health care services, as defined in section 330(b)(1) 
of the PHS Act, including health screening, and health counseling and 
education services for residents of public housing, on the premises of 
public housing projects or at other locations immediately accessible to 
residents of public housing;
    (2) Referral of residents, as appropriate, to qualified facilities 
and practitioners for necessary field services;
    (3) Outreach services to inform residents of the availability of 
such services (especially high risk women of child-bearing age); and
    (4) Aid to residents in establishing eligibility for assistance 
under entitlement programs (e.g., Medicaid; Women, Infants and Children 
program; Aid to Families with Dependent Children) and in obtaining 
services, under Federal, State and local programs providing health 
services, mental health services, or social services.
    In addition, applicants may also provide the following optional 
services:
    (1) Training of public housing residents to provide health 
screening and educational services; and
    (2) Health services to individuals who are not residents of public 
housing, if those services will be provided to such individuals under 
the same terms and conditions as such services are provided to the 
residents.

Restrictions on the Use of Grant Funds

    The following restrictions apply to the use of grants funds:
    (1) The applicant may not expend more than 10 percent of the 
Federal grant funds for the purpose of administering the grant;
    (2) Grant funds may not be used for inpatient services;
    (3) Grants funds may not be used to make cash payments to intended 
recipients of primary health services, or health counseling and 
education services; and
    (4) Grant funds may not be used to purchase or improve real 
property (other than minor remodeling of improvements to existing real 
property) or to purchase major medical equipment or motor vehicles.

    Note: Upon request by the applicant, demonstrating that the 
purposes of the project cannot otherwise be carried out, the 
Secretary may waive the restriction in paragraph [4].

    In selecting applicants for funding, preference is mandated by 
legislation and will be given to applicants that are: (1) Resident 
Management Corporations (RMC) as defined under Section 20 of the U.S. 
Housing Act of 1937; or (2) entities receiving funds under either 
Section 330 of the PHS Act (Community Health Centers) or Section 340 of 
the PHS Act (Health Care for the Homeless Programs).

Evaluation Criteria for Noncompeting Continuation Grants

    Review of noncompeting continuation applications will be based on 
the following criteria:
    (1) The grantee's progress in achieving stated program goals and 
objectives;
    (2) The grantee's ability to resolve any outstanding issues raised 
during the review of its previous year's grant application;
    (3) The adequacy of the grantee's proposed project plan;
    (4) The grantee's history of compliance with reporting 
requirements; and
    (5) The adequacy and appropriateness of the proposed budget.

Requirements for Competing Applicants

    Compliance with the following statutory requirements will be 
reviewed:
    (1) Demonstrated evidence that applicant has consulted with 
residents regarding the preparation of the grant application, ensuring 
that a process is in place for ongoing consultation with the residents 
regarding the planning and administration of the grant program;
    (2) Demonstrated evidence of leadership and management structures 
necessary to ensure the efficient and effective delivery of health 
services to residents;
    (3) Evidence of established or proposed procedures for fiscal 
control and fund accounting as may be necessary to ensure proper 
disbursement and accounting with respect to the grant;
    (4) Demonstrated capacity to establish and maintain an ongoing 
quality assurance management system with respect to the services 
provided under the grant;
    (5) Evidence demonstrating the applicant's ability to ensure the 
confidentiality of records maintained on residents receiving services;
    (6) Demonstrated capacity of applicant to develop and implement a 
reasonable plan to provide health services through individuals who are 
able to communicate in the language and cultural context of the target 
population or populations; and
    (7) Assurances that the applicant will prepare and submit to the 
Secretary an annual report describing the utilization and costs of 
services provided under the grant, and other information as determined.

Evaluation Criteria for Competing Applicants

    Each competing application will be evaluated on the following:
    (1) Demonstrated evidence of the extent to which an ongoing process 
has been established to document needs of the target population, and to 
track changes in the demographic and health characteristics of the 
community to promote purposeful planning of services to be delivered;
    (2) Demonstrated evidence that proposed services are consistent 
with the problems and concerns identified in the needs assessment, and 
sanctioned by the residents as being appropriate to meet the health 
needs of residents;
    (3) Documented experience and evidence that the service delivery 
model is consistent with the proposed project plan, and is supported by 
the target public housing community;
    (4) Documented evidence that the proposed project staffing plan 
fosters the delivery of planned services in a comprehensive and 
coordinated manner, and promotes continuity of care;
    (5) Documented evidence that the outreach and referral strategies 
promote the continuity of care, increase access to services, and link 
residents to resources which meet a wide range of health and social 
service needs;
    (6) Documented evidence of efforts to strengthen relationships with 
State Medicaid Agencies to enhance financing for primary care services;
    (7) Evidence which supports the reasonableness of the proposed 
budget, and adequacy of the budget justification;
    (8) Documented evidence of having successfully developed and 
implemented health services programs for residents of public housing, 
which must include examples of managing the delivery of health services 
to this population;
    (9) Documented evidence of having successfully incorporated the 
residents of public housing in the development, implementation and 
management of the health services program; and
    (10) Documented evidence of an effective working relationship with 
public housing resident organization(s) in the target public housing 
community.

II. Minority Community Health Coalition Demonstration Program Related 
to HIV/AIDS Centered Education and Prevention

Funding

    Grant awards for the Minority Community Health Coalition (MCHC) 
program will be made for amounts up to approximately $100,000 each for 
approximately 5 new projects for up to 3 years. A special initiative 
exists between the Office of Minority Health (OMH) and the Bureau of 
Primary Health Care (BPHC) aimed specifically at the Section 340A 
Public Housing Primary Care (PHPC) grantees. Only those grantees or 
applicants approved for FY 1994 funding, who have not previously 
received OMH/MCHC funds, are eligible for MCHC grants. Proposals for 
this OMH supplemental program must be submitted as part of the 
application for the PHPC grant.

Project Requirements

    Grantees will be required: To develop community health coalitions; 
to identify minority-targeted health education and prevention 
strategies; and to implement the strategies they have identified. These 
strategies will help eliminate or reduce the risk for acquiring or 
transmitting HIV, and other health problems that are acquired and/or 
transmitted or associated with similar risk behaviors. The categories 
must include tuberculosis (TB), substance abuse and sexually-
transmitted diseases (STD), and hepatitis B. Although TB is not 
directly related to risk behaviors underlying HIV transmission, it is a 
serious health problem aggravated by HIV infection. It warrants special 
attention in HIV education/prevention information because of its high 
level of communicability.

Evaluation Criteria

    Proposals for the demonstration program will be evaluated on the 
following:
    (1) The relative need of the population to be served for the 
proposed HIV/AIDS centered education/prevention program;
    (2) The adequacy of the proposed plan to assure the development and 
operation of an effective coalition, which should include involvement 
of the target population;
    (3) The appropriateness of coordination and linkages with State and 
local health departments and other existing HIV-related activities such 
as the federally funded Ryan White Consortia;
    (4) The appropriateness of the proposed staffing pattern;
    (5) The adequacy of community commitment and coordination to 
develop the proposed coalition, including evidence of appropriate 
community participation and endorsement, and documentation of 
commitment, e.g., MOAs and MOUs;
    (6) The reasonableness of the proposed budget and adequacy of the 
budget justification;
    (7) The adequacy of the evaluation plan in measuring the 
coalition's effectiveness in a quantifiable fashion; and
    (8) The extent to which the demonstration activity will be 
coordinated with the activities under the Public Housing Primary Health 
Care program.

Eligibility

    Only those grantees or applicants approved for FY 1994 funding, who 
have not previously received OMH/MCHC funds, are eligible for MCHC 
grants.

Other Award Information

    This program has been determined to be a program which is subject 
to the provisions of Executive Order 12372, 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 kit, to be 
made available under this notice, will contain a listing of States 
which have chosen to set up a review system and will provide a State 
point of contact (SPOC) in the State for that review. Applicants (other 
than Federally-recognized Indian tribal governments) should contact 
their 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 
appropriate application deadline date. The BPHC does not guarantee that 
it will accommodate or explain its response to State process 
recommendations received after the due date.

Public Health System Reporting Requirement

    This program is subject to the Public Health System Reporting 
Requirement (reporting requirements have been approved by the Office of 
Management and Budget--0937-0195). Under this requirement, 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:
    (1) A copy of the face page of the application (SF 424).
    (2) A summary of the project (PHSIS), not to exceed one page, which 
provides:
    a. A description of the population to be served;
    b. A summary of the services to be provided; and
    c. A description of the coordination planned with the appropriate 
State and local health agencies.

    The Catalog of Federal Domestic Assistance number for this 
program is 93.927.

    Dated: April 21, 1994.
John H. Kelso,
Acting Administrator.

Appendix--Regional Grants Management Officers

Region I: Mary O'Brien, Grants Management Officer, PHS Regional Office 
I, John F. Kennedy Federal Building, Boston, MA 02203 (617) 565-1482
Region II: Frank DiGiovanni, Grants Management Officer, PHS Regional 
Office II, Room 3300, 26 Federal Plaza, New York, NY 10278 (212) 264-
4496
Region III: Martin J. Bree, Grants Management Officer, PHS Regional 
Office III, 3535 Market St., P. O. Box 13716, Philadelphia, PA 19101, 
(215) 596-6653
Region IV: Wayne Cutchens, Grants Management Officer, PHS Regional 
Office IV, Room 1106, 101 Marietta Tower, Atlanta, GA 30323, (404) 331-
2597
Region V: Lawrence Poole, Grants Management Officer, PHS Regional 
Office V, 105 West Adams Street, 17th Floor, Chicago, IL 60603, (312) 
353-8700
Region VI: Joyce Bailey, Grants Management Officer, PHS Regional Office 
VI, 1200 Main Tower, Dallas, TX 75202, (214) 767-3885
Region VII: Michael Rowland, Grants Management Officer, PHS Regional 
Office VII, Room 501, 601 East 12th Street, Kansas City, MO 64106, 
(816) 426-5841
Region VIII: Susan Jaworowski, Grants Management Officer, PHS Regional 
Office VIII, 1961 Stout Street, Denver, CO 80294, (303) 844-4461
Region IX: Al Tevis, Grants Management Officer, PHS Regional Office IX, 
50 United Nations Plaza, San Francisco, CA 94102, (415) 556-2595
Region X: James Tipton, Grants Management Officer, PHS Regional Office 
X, Mail Stop RX 26, 2201 Sixth Avenue, Seattle, WA 98121, (206) 616-
2473

[FR Doc. 94-12550 Filed 5-20-94; 8:45 am]
BILLING CODE 4160-15-P