[Federal Register Volume 59, Number 101 (Thursday, May 26, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-12844]


[[Page Unknown]]

[Federal Register: May 26, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[Announcement Number 475]

 

State-Based Capacity Building Projects for the Prevention of 
Primary Disabilities and Secondary Conditions

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1994 funds for cooperative agreements 
for state-based capacity building projects to prevent primary 
disabilities and secondary conditions. Financial assistance is being 
provided to develop or expand capacity of States to prevent 
disabilities through public health leadership, coordination of 
services, public health surveillance, technical assistance, and 
implementation and evaluation of community intervention programs.
    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of ``Healthy People 
2000,'' a PHS-led national activity to reduce morbidity and mortality 
and improve the quality of life. This announcement is related to the 
areas of Health Promotion, Health Protection, Preventive Services, and 
Surveillance and Data Systems. (For ordering a copy of ``Healthy People 
2000,'' see the section ``Where to Obtain Additional Information.'')

Authority

    This program is authorized by section 301(a) (42 U.S.C. 241(a)) and 
Section 317 (42 U.S.C. 247(b)) of the Public Health Service Act, as 
amended.

Smoke-Free Workplace

    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.

Eligible Applicants

    Eligible applicants are the official public health departments of 
States or other State agencies or departments that: (1) are not current 
recipients of an award under this program; or (2) are current 
recipients whose funding ends in FY 1994. This includes the District of 
Columbia, American Samoa, the Commonwealth of Puerto Rico, the Virgin 
Islands, the Federated States of Micronesia, Guam, the Northern Mariana 
Islands, the Republic of the Marshall Islands, and the Republic of 
Palau.
    Except in the case of currently funded States where programmatic 
relationships are established, State agencies applying under this 
announcement that are other than the official State health department 
must provide written concurrence from that agency. Only one application 
from each State may enter the review process and be considered for an 
award under this program.

Availability of Funds

    Approximately $4,000,000 is available in FY 1994 to fund 9 to 11 
awards. It is expected that awards for States newly funded under this 
announcement will range from $200,000 to $250,000. It is also expected 
that awards for currently funded States that receive renewal funding 
under this announcement will range from $320,000 to $450,000. It is 
expected that the awards will begin on or before September 30, 1994, 
and made for a 12-month budget period within a two year project period. 
Funding estimates may vary and are subject to change. Continuation 
awards within the project period will be made on the basis of 
satisfactory progress and the availability of funds.
    The CDC currently funds 28 state-based capacity building projects. 
Ten of these States will complete their project periods in September 
1994. The CDC expects to make non-competing continuation awards to the 
remaining 18 States in September 1994. Therefore, only a portion of the 
total FY 1994 national appropriations for State-based capacity building 
projects will be available to support States competing under this 
announcement.

Use of Funds

    These awards may be used for personnel services, supplies, 
equipment, travel, subcontracts, and services directly related to 
project activities. Project funds may not be used to supplant State or 
local funds available for disabilities prevention, for construction 
costs, to lease or purchase facilities or space, or for patient care. 
Continuation awards beyond the first budget year will be based on the 
availability of funds and on the satisfactory progress of recipients in 
achieving project goals and objectives.

Purpose

    The purpose of these cooperative agreements is to develop State 
capacity to reduce the incidence and severity of primary disabilities 
and secondary conditions. These awards are being made to establish and 
maintain State leadership through the development of basic State core 
capacity and conduct of special prevention projects in targeted 
disability groups. Targeted disability groups are categories of primary 
disabilities and their associated secondary conditions. These include 
selected developmental disabilities, traumatic brain and spinal cord 
injuries, and selected adult chronic conditions. States may conduct 
special prevention projects in one or more of these targeted disability 
groups. Core capacity activities should include appropriate 
collaborations with State and community agencies, advocacy 
organizations, schools of public health, and other academia/
universities including minority institutions. State-based projects must 
provide technical assistance and increase the knowledge base necessary 
to design, implement, and evaluate surveillance and interventions that 
prevent disabilities. State-based projects should become model 
disability prevention programs capable of replication in other States.

Program Requirements

    Applicants must indicate how their programs will meet this basic 
state-level core capacity for disabilities prevention. State projects 
must include strong public health management, a representative advisory 
council and strategic planning process, access to sound epidemiologic 
and public health surveillance capacity, and competence in guiding the 
conduct of community intervention and health promotion activities.
    To that end, applicants must propose an office of disabilities 
prevention that includes a full-time manager/coordinator position with 
the authority to carry out project requirements. The applicant should 
describe those project resources and staff necessary to meet basic core 
requirements while also coordinating core-related functions and other 
activities that reside outside of the office of disabilities 
prevention.
    Applicants should describe the organization structure and placement 
of the project and how this approach can maximize the State's capacity 
to promote State policy and priority setting. The CDC prefers that 
State offices of disabilities prevention have a program title that 
conveys their state-level coordination functions and responsibilities. 
However, applicants may integrate this office into an established 
agency organization.
    Applicants should describe how they will meet both the requirements 
for basic core capacity and the implementation of special prevention 
projects. Applications will be reviewed and ranked separately for basic 
state-level core capacity and for special prevention projects. Special 
prevention projects will be funded only in States receiving basic core 
capacity awards.

Special Prevention Projects

    The following special prevention projects will be considered for 
funding. Other projects similar in scope considered important by 
applicants should be included as basic state-level core capacity and 
presented in that section of the application. The special prevention 
projects on this list must be completed prior to the start of the last 
quarter of the project period.
    1. Assess the long-term morbidity and the consequences of specific 
secondary conditions associated with any of the following primary 
disabling conditions: spina bifida, cerebral palsy, sickle cell 
disease, fetal alcohol syndrome, traumatic brain injury, traumatic 
spinal cord injury, arthritis, osteoporosis, and urinary incontinence;
    2. Design, implement or evaluate new, or expand the use of an 
existing preventive intervention in one of the following secondary 
conditions: (a) pressure sores in persons with mobility impairments; 
(b) progressive disability in persons with arthritis; (c) behavioral 
problems in children with fetal alcohol syndrome;
    3. Determine the preventive health care needs in consumer-managed 
activities such as centers for independent living, assess the 
feasibility of conducting interventions, and/or implement health 
promotion programs in those settings;
    4. Measure or evaluate the impact of one of the following: (a) 
heavy prenatal alcohol exposure on developmental disabilities; (b) 
early intervention programs, e.g., home visiting programs, Head Start, 
educational child care, etc., in children at environmental risk for 
mental retardation; or (c) early intervention programs for women at 
risk for having a child with fetal alcohol syndrome;
    5. Conduct a prevention program targeted to high risk groups in 
order to prevent fetal alcohol syndrome;
    6. Develop model public health surveillance for mild and moderate 
traumatic brain injury;
    7. Define the impact of firearm injury, especially related to 
traumatic brain and traumatic spinal cord injuries, as to outcomes and 
secondary conditions;
    8. Coordinate or conduct community interventions related to the 
prevention of bicycle injuries through increased usage of bicycle 
helmets and prevention of motor vehicle injuries through increased use 
of occupant protection;
    9. Assess the prevalence of risk factors for osteoporosis and 
establish an intervention program addressing high-risk groups;
    10. Develop and conduct education programs for physicians and the 
public so that persons with urinary incontinence will seek and receive 
proper treatment.
    Detailed design and implementation guidance regarding these special 
prevention projects is available from CDC. Please refer to the ``Where 
to Obtain Additional Information'' section.

Budget and Project Costs

    This program has no statutory matching requirement; however, 
applicants should demonstrate their capacity to support a portion of 
project costs, increase cost-sharing potential over time, and identify 
other funding sources for expanding the project. Applicants must 
prepare separate budget requests for both the basic State core capacity 
and each special prevention project (identifying both Federal and non-
Federal sources).
    While CDC has not set specific limits as to the proportion of the 
total application budget request that should be directed to basic State 
core capacity, it anticipates that funds to support such core capacity 
will range from $200,000 to $330,000.
    It is also anticipated that each special prevention project will 
have a budget ranging from $40,000 to $60,000. Applicants may propose 
special prevention projects at a budget level below or above this 
range. The overall quality of proposed special prevention projects, 
taking into account total funds available, will be the major factor as 
to those projects that will be funded. The CDC expects that no State 
will receive awards for more than three special prevention projects.

Cooperative Activities

    In conducting activities to achieve the purposes of this program, 
the recipient shall be responsible for the activities under A. 
(Recipient Activities) and CDC shall be responsible for the activities 
listed under B. (CDC Activities).

A. Recipient Activities

    1. Develop an identified, highly visible state-based program for 
the prevention of disabilities and secondary conditions as related to 
the indicated core capacity functions;
    2. Establish and operate a state-based office of disabilities 
prevention, support an advisory body, develop and implement the State 
strategic plan, establish coordination with other disabilities 
prevention-related agencies, develop project objectives and time 
frames, and provide technical assistance;
    3. Implement statewide surveillance, using existing data, for all 
disabilities based on the collective impact on functional limitations;
    4. Develop and implement public health surveillance for the 
targeted disability group(s);
    5. Promote prevention planning in communities, conduct or guide 
intervention activities, and evaluate their effectiveness; and
    6. Design, implement, and evaluate special prevention projects.

B. CDC Activities

    1. Provide scientific, programmatic, and technical assistance in 
the planning, operation, and evaluation of surveillance and community 
projects;
    2. Provide programmatic assistance in administrative and 
organizational aspects of project operations and provide information on 
project activities in other States and national initiatives;
    3. Support project staff by conducting training programs, 
conferences, and workshops to enhance skills and knowledge;
    4. Provide a reference point for sharing regional and/or national 
data pertinent to targeted disabilities; and
    5. Assist in research and in studying the effectiveness of specific 
prevention and intervention strategies.

Evaluation Criteria for Basic Core Capacity (Total 100 Points)

1. Evidence of Need and Understanding of the Problem: (20 Points)

    Evaluation will be based on:
    a. The applicant's description and understanding of the 
disabilities problem in the State as evidenced by estimates of 
incidence and/or prevalence, demographic indicators, scope of 
disabilities and their severity, and costs associated with specific 
disabilities;
    b. The applicant's description of current prevention activities 
within the State. This description should address available resources, 
populations-at-risk, knowledge gaps, current relationships and 
potential to enroll other organizations in support of the project, and 
the applicant's assessment of program effectiveness;
    c. The applicant's understanding of the impact of secondary 
conditions in the State and the applicant's description of its future 
capacity to re-direct the program to the prevention of secondary 
conditions.

2. Technical Approach and Core Capacity: (35 Points)

    Evaluation will be based on:
    a. The capability of the applicant to ensure that the basic 
components of core state-level capacity will be promoted and 
implemented, including the rationale for the selection of the targeted 
disability group(s);
    b. The proposed plan to establish and operate the office of 
disabilities prevention, and ensure its capability to function as a 
coordinating focus and provide technical assistance throughout the 
State;
    c. The plan to establish the advisory body including its 
organizational composition and intended impact on policy, planning, and 
oversight for prevention activities; including an indication of how it 
will complement other such councils in the State;
    d. The approach to develop and implement the State strategic plan 
for the prevention of disabilities;
    e. The reasonableness, feasibility, and logic of the designed 
project objectives, including the overall work plan, timetable for 
accomplishment, and the strength of the proposed evaluation plan;
    f. The described preventive services for low income and minority 
populations and how access for persons with disabilities to project 
services, opportunities, and facilities will be achieved.

3. Surveillance: (25 Points)

    Evaluation of this criteria will be based on demonstration of the 
applicant's core epidemiologic capacity to conduct, facilitate, 
analyze, and/or assess surveillance data in functional limitations and 
the targeted disability group(s), including its design, methods for 
collection, quality assurance program, timelines for analysis or 
determinants of data quality and gaps, collaborative support and intra/
inter-agency agreements for data sharing, data linkage, access and 
analysis potential, and dissemination capacity. This also includes the 
capability to conduct expanded surveillance and/or epidemiologic 
studies as part of basic state-level core activities.

4. Community Interventions: (15 Points)

    Evaluation will be based on the applicant's description of planning 
efforts and anticipated methods to design, facilitate, offer technical 
assistance, and/or conduct and evaluate health promotion and other 
community intervention projects under its core capacity.

5. Cost-Sharing: (5 Points)

    This criteria will be evaluated on evidence of personnel and 
financial contributions to the project.

6. Budget Justification/Adequacy of Facilities: (Not Scored)

    Evaluation of the proposed budget will be based on the 
reasonableness, concise and clear justification, and consistency with 
the intended use of cooperative agreement funds.

Evaluation Criteria for Special Prevention Projects (100 Points)

1. Evidence of Need: (10 Points)

    Evaluation will be based on the description and documentation of 
need for the project and the importance of how the proposed activity 
relates to that need, including its basis in data sources, and support 
or endorsement by an advisory function, public health leadership, and/
or other State priorities.

2. Project Description: (30 Points)

    Evaluation will be based on the description of the project; the 
appropriateness and specificity of goals, objectives, and timelines; 
and the applicant's potential for achieving the expected results.

3. Technical Approach: (30 Points)

    Evaluation will be based on the description of the methods to be 
used to implement the project, staff qualifications and resources 
available, commitments and support to be provided from collaborating 
organizations, and how the core functions will be used to support the 
special prevention project.

4. Evaluation Plan: (30 Points)

    Evaluation will be based on the methods presented to measure 
specific outcomes and evaluate the entire project including the 
proposed use and dissemination of results.

5. Budget Justification: (Not Scored)

    This includes the reasonableness, appropriateness, and clarity of 
the budget request including the necessary documentation of facilities 
and resources to be applied to support the proposed project.

Funding Priorities

    Subsequent to decisions for basic state-level core capacity awards, 
funding for special prevention projects will consider geographical 
balance and distribution among all targeted disability groups.
    Public comments are not being solicited regarding the funding 
priority because time does not permit solicitation and review prior to 
the funding date.

Executive Order 12372

    Applications are subject to the Intergovernmental Review of Federal 
Programs as governed by Executive Order (E.O.) 12372. E.O. 12372 sets 
up a system for State and local government review of proposed Federal 
assistance applications. Applicants should contact their State Single 
Point of Contacts (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 SPOCs of each affected State. A 
current list is included in the application kit. If SPOCs have any 
State process recommendations on applications submitted to CDC, they 
should forward them to Henry S. Cassell, III, Grants Management 
Officer, Grants Management Branch, Procurement and Grants Office, 
Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry 
Road, NE., room 300, Mailstop E-13, Atlanta, Georgia 30305, no later 
than 60 days after the deadline date for new and competing awards. The 
granting agency does not guarantee to ``accommodate or explain'' State 
process recommendations it receives after that date.

Public Health System Reporting Requirements

    This program is not subject to the Public Health System Reporting 
Requirements.

Catalog of Federal Domestic Assistance Number

    The Catalog of Federal Domestic Assistance number is 93.184.

Other Requirements

A. Paperwork Reduction Act

    Projects that involve the collection of information from 10 or more 
individuals and funded by the State-Based Capacity Building Project 
will be subject to review by the Office of Management and Budget (OMB) 
under the Paperwork Reduction Act.

B. Human Subjects

    If the proposed project involves research on human subjects, the 
applicant must comply with the Department of Health and Human Services 
Regulations, 45 CFR Part 46, regarding the protection of human 
subjects. Assurance must be provided to demonstrate that the project 
will be subject to initial and continuing review by an appropriate 
institutional review committee. The applicant will be responsible for 
providing assurance in accordance with the appropriate guidelines and 
form provided in the application kit.

Application Submission and Deadline

    The original and two copies of the application PHS Form 5161-1, 
Revised 7/92, OMB Control Number 0937-0189), must be submitted to Mr. 
Henry S. Cassell, III, Grants Management Officer, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., room 300, Mailstop E-
13, Atlanta, Georgia 30305, on or before July 14, 1994.
    1. Deadline: Applications will 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 date and received in time for 
submission to the objective review group. (Applicants must 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.)
    2. Late Applications: Applications that do not meet the criteria in 
1.(a) or 1.(b) above are considered late applications. Late 
applications will not be considered in the current competition and will 
be returned to the applicant.

Where To Obtain Additional Information

    A complete program description, information on application 
procedures, an application package, and business management technical 
assistance may be obtained from Georgia L. Jang, Grants Management 
Specialist, Grants Management Branch, Procurement and Grants Office, 
Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry 
Road, NE., room 300, Mailstop E-13, Atlanta, Georgia 30305, telephone 
(404) 842-6814. Programmatic technical assistance including additional 
guidance related to basic core capacity and special prevention projects 
may be obtained from Joseph B. Smith, Disabilities Prevention Program, 
National Center for Environmental Health, Centers for Disease Control 
and Prevention (CDC), 4770 Buford Highway, NE., Building 101, Mailstop 
F-29, Atlanta, Georgia 30341, telephone (404) 488-7080.
    Please refer to Program Announcement No. 475 when requesting 
information and submitting an application.
    Potential applicants may obtain a copy of ``Healthy People 2000'' 
(Full Report; Stock Number 017-001-00474-0) or ``Healthy People 2000'' 
(Summary Report; Stock Number 017-001-00473-1) referenced in the 
Introduction through the Superintendent of Documents, Government 
Printing Office, Washington, DC 20402-9325, telephone (202) 783-3238.

    Dated: May 20, 1994.
Ladene H. Newton,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 94-12844 Filed 5-25-94; 8:45 am]
BILLING CODE 4163-18-P