[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]
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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.
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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