[Federal Register Volume 59, Number 141 (Monday, July 25, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-18049]


[[Page Unknown]]

[Federal Register: July 25, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
RIN 0905-ZA68

 

Special Project Grants; Maternal and Child Health (MCH) Services; 
MCH Community Integrated Service Systems (CISS) Set-Aside Program

AGENCY: Health Resources and Services Administration, PHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA), in 
collaboration with the Administration for Children, Youth and Families 
(ACYF), announces the availability of fiscal year 1994 funds for 
Maternal and Child Health (MCH) Community Integrated Service Systems 
(CISS) Set-Aside Program grants authorized under section 502(b)(1)(A) 
of Title V of the Social Security Act, to support development and 
expansion of successful community integrated service strategies. 
Funding for new CISS projects is Congressionally focused on development 
of home visiting programs which carry out the intent of the ``Home 
Visiting Services for At-Risk Families'' Program, as authorized by 
Title V of the ADAMHA Reorganization Act (P.L. 102-321). Funds were 
appropriated under Public Law 103-112. $2.5 million will be available 
to support 50 new CISS projects of $50,000 per grant for a one year 
budget period. Awards will be for one year, beginning October 1, 1994.
    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives and goals of Healthy 
People 2000, a PHS-led national activity for setting priority areas. 
The MCH CISS program addresses the Healthy People 2000 objectives 
related to improving maternal, infant, child and adolescent health by 
developing comprehensive, coordinated, culturally-competent and family 
centered services at the community level which address health and 
related needs for all pregnant women, infants, children, and their 
families. 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 tobacco 
products. This is consistent with the PHS mission to protect and 
advance the physical and mental health of the American people.

ADDRESSES: Grant applications for the MCH CISS Set-Aside Program (PHS 
form #5161-1, approved under OMB #0937-0189) must be obtained from and 
submitted to: Chief, Grants Management Branch, Maternal and Child 
Health Bureau, Room 18-12, Parklawn Building, 5600 Fishers Lane, 
Rockville, Maryland 20857, (301) 443-1440. Potential applicants should 
specifically request the application kit with guidance materials for 
CISS Home Visiting grant projects.

DATES: The application deadline date is June 30, 1994. An advance 
notice of application deadline was published on May 10, 1994 at 59 FR 
24174. Applications will have met the deadline 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 David Heppel, M.D., Director, 
Division of Maternal, Infant, Child, and Adolescent Health, Maternal 
and Child Health Bureau, Room 18-A-39, Parklawn Building, 5600 Fishers 
Lane, Rockville, Maryland 20857, telephone 301-443-2250. Requests for 
information concerning business management issues should be directed 
to: John Gallicchio, Grants Management Officer (GMO), at the address 
listed in the ADDRESS section.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

    At the request of Congress, new fiscal year (FY) 1994 CISS funds 
will focus on the home visiting approach described in section 501(a)(3) 
of the Social Security Act and will begin to implement the intent of 
the ``Home Visiting Services for At-Risk Families'' program, authorized 
by Title V of the ADAMHA Reorganization Act. The purpose of the latter 
program is to increase the frequency of early prenatal care, improve 
birth outcomes, increase health and related social services to at-risk 
families, and to reduce the incidence of child abuse and neglect. To 
optimize the CISS funds devoted to at-risk home visiting and to amplify 
the impact of the Family Preservation and Support Services initiative, 
HRSA and ACYF are collaborating to promote State efforts to develop 
comprehensive systems of services--including home visiting--that meet 
both the health and welfare needs of families.

Inter-Agency Coordination

    These CISS/Home Visiting for At-Risk Families (HVAF) grants are 
intended to be a coordinated initiative with the Administration for 
Children, Youth and Families (ACYF) Family Preservation and Family 
Support (FP/FS) Services program, as authorized under Title IV-B of the 
Social Security Act. The CISS/HVAF grants will complement FP/FS 
planning activities to promote development of comprehensive systems of 
services which meet both the health and social service needs of 
families.
    The ACYF will participate with the HRSA in developing the program 
guidance for the CISS/HVAF initiative, monitoring the CISS home 
visiting awards made during FY 1994, and providing ongoing technical 
assistance and consultation to the HRSA regarding the required 
collaboration and linkages between a CISS/HVAF applicant and the 
relevant State Title IV-B Child Welfare agency. Grants funded under 
this program are expected to exemplify full, effective collaboration 
between Title IV-B and Title V agencies.

Purpose

    Funds are available in FY 1994 to support planning activities that 
aim to integrate community systems of care for vulnerable children and 
their families. Such an integrated system would include at-risk 
pregnant women, as well as their children and families as target 
populations; pay particular attention to the increased resources needed 
by children with special health care needs and their families; 
emphasize primary prevention and family support activities; and where 
appropriate use a system of home visiting as a significant component of 
any community system of care.
    All CISS/HVAF activities are intended to be conducted within the 
context of overall State efforts to develop comprehensive community 
based systems of services and to focus on unmet needs and service gaps 
identified in the State's MCH Block Grant plan and FP/FS planning 
process. (Project elements relating to collaboration with ACYF-
sponsored programs are described more fully in the program guidance 
included in the application packet.)

Funding Category

    At the request of Congress, the sole funding category for new CISS 
projects in FY 1994 is the home visiting strategy described in section 
501(a)(3), i.e., case management services provided in the home.

Special Concerns

    MCH CISS Set-Aside Program grantees are expected to participate in 
community-wide, comprehensive planning activities that coordinate 
primary care, public health and child welfare activities; to place 
emphasis on rural communities and metropolitan areas with high rates of 
infant mortality and low birth weights, especially among minority 
populations; and, to coordinate with the 15 communities in the Nation 
which have received grants from the HRSA under the Healthy Start 
initiative. Healthy Start communities include: Aberdeen Area Indian 
Nations, NE/ND/SD; Baltimore MD; Birmingham, AL; Boston, MA; Chicago, 
IL; Cleveland, OH; Detroit, MI; Lake County, IN; New Orleans, LA; New 
York, NY; Oakland, CA; Philadelphia, PA; Pittsburgh, PA; PeeDee Region, 
SC; and, Washington, DC.
    In its administration of the MCH Services Block Grant, the MCHB 
places special emphasis on improving service delivery to women and 
children from culturally identifiable populations who have been 
disproportionately affected by barriers to care. This means that FY 
1994 MCH CISS/HVAF projects are expected to involve members of ethno-
culturally distinct groups in planning activities, unless there are 
compelling programmatic or other justifications for not doing so.
    Projects funded under the MCH CISS Set-Aside Program are selected 
and administered under the same procedures and practices as are 
currently in effect for the MCH Special Projects of Regional and 
National Significance (SPRANS) set-aside activities. The regulation 
implementing the MCH SPRANS Set-Aside Program was published in the 
March 5, 1986, issue of the Federal Register at 51 FR 7726 (42 CFR Part 
51a).

Availability of Funds

    $2.5 million is available under the MCH CISS Set-Aside Program to 
support approximately 50 HVAF projects, not exceeding $50,000 per award 
for a one year budget period. Awards will be made for project periods 
of one year. Applicants are advised that support for implementation of 
planning components developed under this program will not be available 
through the MCH CISS Set-Aside Program after FY 1994.

Eligible Applicants

    Eligibility for funding is limited to a single application from 
each State. State Maternal and Child Health (MCH) and Child Welfare 
(CW) agencies must either act as co-applicants or collaborate in the 
identification of the applicant. Each CISS/HVAF grant award in FY 1994 
is contingent upon a funded Family Preservation and Support Services 
program. Well defined roles for the State MCH and Title IV-B agencies 
are essential to ensure maximum collaboration and coordination across 
the MCH-CW service systems. Projects must promote community/State 
partnerships.

Project Review and Funding

    The Department will review applications as competing applications 
and will fund those which, in the Department's view, are consistent 
with the statutory purpose of the CISS set aside program; focus on 
coordination and collaboration across the MCH-CW service systems; pay 
particular attention to involvement of women and persons from 
culturally distinct populations; and, address the achievement of 
applicable Healthy People 2000 objectives in communities with 
demonstrated need.
    Final funding decisions for CISS/HVAF grants are the responsibility 
of the Director, MCHB, and will be carried out in consultation with the 
Commissioner, ACYF.

Review Criteria

    Review panels composed mainly of nonfederal members will evaluate 
applications for awards. Staff from MCHB and ACYF will also serve on 
review panels. The following review criteria will be used to review and 
evaluate CISS/HVAF applications:

--Documentation of joint involvement of State MCH and State Child 
Welfare agencies in the development of the application and their intent 
to work together in developing the health component of the Five-Year 
FP/FS State Plan including a time-framed strategy to ensure completion 
of required tasks.
--Extent of existing and planned collaborative activities to be 
conducted in conjunction with any MCH systems initiatives including the 
MCH Block Grant, MCH State Systems Development Initiative (SSDI), 
Community Integrated Service Systems (CISS) or related Special Projects 
of Regional and National Significance (SPRANS) and the assurance of 
mechanisms to promote collaboration between MCH and CW in developing 
the State's MCH Services Block Grant application.
--Extent to which CISS/HVAF applicants will build on existing and 
planned collaborative initiatives with other agencies (health, 
education, mental health, justice) to link and coordinate services for 
children and families at the community level.
--The quality and feasibility of the project plan or methodology and 
its relation to the project's goals and objectives.
--Level of proposed community input and involvement in design of the 
plan.
--Use of requested grant funds to carry out proposed health planning 
activities.

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, 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:
    (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 and local health agencies.

Executive Order 12372

    The Maternal and Child Health Services Block Grant program has been 
determined to be a program which is not subject to the provisions of 
Executive Order 12372 concerning intergovernmental review of Federal 
programs.

    The OMB Catalog of Federal Domestic Assistance number is 93.110.

    Dated: July 20, 1994.
Ciro V. Sumaya,
Administrator.
[FR Doc. 94-18049 Filed 7-22-94; 8:45 am]
BILLING CODE 4160-15-P