[Federal Register Volume 59, Number 240 (Thursday, December 15, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-30760]


[[Page Unknown]]

[Federal Register: December 15, 1994]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
 

Emergency Medical Services for Children Demonstration Grants

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

ACTION: Notice of availability of funds.

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SUMMARY: The HRSA in collaboration with the National Highway Traffic 
Safety Administration (NHTSA) announces the availability of fiscal year 
(FY) 1995 funds for grants authorized under section 1910 of the PHS 
Act. These discretionary grants will be made to States or accredited 
schools of medicine to support projects for the expansion and 
improvement of emergency medical services for children (EMSC). Funds 
appropriated by Public Law 103-112 will be used for this purpose. 
Awards made under the EMSC program authority are for project periods of 
up to 2 years. Within the HRSA, EMSC grants are administered by the 
Maternal and Child Health Bureau (MCHB).
    The NHTSA participated with the MCHB in developing program 
priorities for the EMSC program for FY 1995. The NHTSA will share the 
Federal monitoring responsibilities for EMSC awards made during FY 1995 
and will continue to provide ongoing technical assistance and 
consultation in regard to the required collaboration/linkages between 
applicants and their Highway Safety Offices and Emergency Medical 
Services Agencies for the State(s). Grantees funded under this program 
are expected to work collaboratively with the State trauma systems 
planning and development projects funded by the Bureau of Health 
Resources Development, HRSA; and the State agency or agencies 
administering the Maternal and Child Health (MCH) and the Children with 
Special Health Care Needs (CSHCN) programs under the Maternal and Child 
Health (MCH) Services Block Grant, Title V of the Social Security Act 
(42 U.S.C. 701).
    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 EMSC grant program will 
directly address the Healthy People 2000 objectives related to 
emergency medical services and trauma systems linking prehospital, 
hospital, and rehabilitation services in order to prevent trauma deaths 
and long-term disability. 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, 
D.C. 20402-9325 (telephone 202 783-3238).
    The PHS 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: Grant applications for Emergency Medical Services for 
Children Demonstration Grants (Revised PHS form #5161-1, approved under 
OMB #0937-0189) must be obtained from and submitted to: Grants 
Management Branch, Maternal and Child Health Bureau, Health Resources 
and Services Administration, Room 18-12, Parklawn Building, 5600 
Fishers Lane, Rockville, Maryland 20857, Attn: EMSC, telephone 301 443-
1440.

DATES: The application deadline date is March 17, 1995. Competing 
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 competing applications or those sent to an address other than 
specified in the ADDRESSES section will be returned to the applicant.

FOR FURTHER INFORMATION: Requests for technical or programmatic 
information should be directed to Jean Athey, Ph.D., Division of 
Maternal, Infant, Child and Adolescent Health, Maternal and Child 
Health Bureau, Health Resources and Services Administration, Room 18A-
39, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, 
telephone 301 443-4026. Requests for technical or programmatic 
information from NHTSA should be directed to Garry Criddle, R.N., CDR, 
USCG/USPHS, Department of Transportation, NHTSA EMS Division, NTS-42, 
400 7th Street SW, Washington, DC 20590, telephone 202 366-5440. 
Requests for information concerning business management issues should 
be directed to: Maria Carter, Grants Management Specialist, Grants 
Management Branch, Maternal and Child Health Bureau, Room, 18-12, 
Parklawn Building, 5600 Fishers Lane, Rockville, MD 20857, telephone 
301 443-1440.
    In addition, this program funds two national EMSC resource centers 
that are available to provide technical assistance and support to 
applicants, particularly in the areas of: (1) Understanding EMSC 
terminology; (2) developing a manageable approach to EMSC 
implementation; (3) obtaining local support for the grant application 
process; (4) facilitating development of community linkages for a 
collaborative effort; (5) identifying products of previously-funded 
EMSC projects of interest to potential applicants; and (6) offering 
advice on grant writing. Applicants may contact: James Seidel, M.D., 
Ph.D., or Deborah Henderson, R.N., M.A., National EMSC Resource 
Alliance, Research and Education Institute, Harbor/UCLA Medical Center, 
1001 West Carson Street, Suite S, Torrance, CA 90502, telephone 310 
328-0720; or Jane Ball, R.N., Dr. P.H., EMSC National Resource Center, 
Children's National Medical Center, Emergency Trauma Services, 111 
Michigan Ave., N.W., Washington, DC 20010, telephone 202 884-4927.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

    The Emergency Medical Services for Children statute (Section 1910 
of the PHS Act, as amended) establishes a program of two-year grants to 
States, through a State-designated agency, or to an accredited medical 
school within the State, for projects for the expansion and improvement 
of emergency medical services systems for children who need treatment 
for trauma or critical illness. For purposes of this grant program, the 
term ``State'' includes the 50 States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Virgin Islands, the Northern Mariana 
Islands, Guam, American Samoa, the Republic of Palau, the Republic of 
the Marshall Islands, and the Federated States of Micronesia. The term 
``school of medicine'' is defined as having the same meaning as set 
forth in Section 799(1)(A) of the PHS Act (42 U.S.C. 295p(1)(A)). 
``Accredited'' in this context has the same meaning as set forth in 
section 799(1)(E) of the PHS Act (42 U.S.C. 295p(1)(E)). It is the 
intent of this grant program to stimulate further development or 
expansion of ongoing efforts in the States to reduce the problems of 
life-threatening pediatric trauma and critical illness. The Department 
does not intend to award grants which would duplicate grants previously 
funded under the Emergency Medical Services Systems Act of 1972 or 
which would be used simply to increase the availability of emergency 
medical services funds allotted to the State under the Preventive 
Health Services Block Grant.

Funding Categories

    There will be four categories of competition for funding this year: 
State planning grants, State systems grants, targeted issue grants, and 
cooperative agreements. States may apply for a grant in only one of the 
first two categories, but are not restricted in applying for the last 
two categories. The table included in this notice includes a breakdown 
of the number of awards, estimated amounts available, and the project 
period for each of the above categories.

Category (1): State Planning Grants

    Planning grants are intended for States that have never received an 
EMSC grant and that are not at a stage of readiness to initiate a full-
scale implementation project. States (or medical schools within those 
States) that have not received prior EMSC implementation grants are the 
only applicants eligible for this category. Planning grants are 
designed to enable a State to assess needs and develop a strategy to 
begin to address those needs. Funds may be used to hire staff to assist 
in the assessment of EMSC needs of the State; obtain technical 
assistance from national, State, regional or local resources; help 
formulate a State plan for the integration of EMSC services into the 
existing State EMS plan; and plan a more comprehensive grant proposal 
based upon a needs assessment performed during the planning grant 
project period. A comprehensive approach, addressing physical, 
psychological, and social aspects of EMSC along the continuum of care, 
should be reflected. An ongoing working relationship with Federal EMSC 
program staff and resource center staff, beginning with the initiation 
of a planning grant application, is strongly encouraged. Budget 
requests in this category should not exceed $50,000. The project period 
is for one year only, with no renewal.

Category (2): State Systems Grants

    This category of grants has two subcategories: implementation 
grants and system enhancement grants. For both subcategories, proposals 
are sought which include strategies and/or models to ensure that 
pediatric emergency care is family centered. ``Family-centered'' 
includes the following key elements of care: maximum possible 
involvement of families in all phases of the EMSC continuum of care; 
clear and continuous communication between family members and the 
emergency care team; attention to the psychosocial needs of all family 
members; cultural competence of providers; consumer (parental) 
involvement in planning and needs assessment; organizational support 
for the formation of parent advocacy groups; and ongoing partnerships 
with such groups.
Subcategory (A): Implementation Grants
    Implementation grants will improve the capacity of a State's 
Emergency Medical Services system to address the particular needs of 
children. Implementation grants are used to assist States in 
integrating research-based knowledge and state-of-the-art systems 
development approaches into the existing State EMS/trauma, MCH and 
CSHCN systems, using the experience and products of previous EMSC 
grantees. The program components of these grants should reflect the 
goals of the draft MCHB/NHTSA Five Year Plan for EMSC. This plan 
outlines the direction of the EMSC program and identifies specific 
objectives for the program (a list of these goals and objectives will 
be included with the application kit). It builds on the 1993 Report for 
EMSC conducted by a blue-ribbon Institute of Medicine panel. The range 
of funding for these grants is anticipated to be $200,000 to $250,000 
per award for each twelve month budget period. Project periods are up 
to two years. Up to six grants will be awarded. For this competition, 
we intend to fund applications from States (and medical schools within 
those States) that have not as yet received support, or that have 
received only partial support under this program as part of a regional 
alliance. This means that approved applications from States (and 
medical schools within those States) with no or very limited prior EMSC 
program support will be funded before approved applications from 
outside this group. Applications will not be accepted for both planning 
grants and implementation grants simultaneously from the same State.
Subcategory (B): System Enhancement Grants
    System enhancement grants will fund activities that represent the 
next logical step or steps to take in institutionalizing EMSC 
activities within the State EMS/trauma, MCH and CSHCN systems and 
achieving program goals outlined in this announcement. The program 
components of these grants should reflect the goals and objectives of 
the draft MCHB/NHTSA Five Year Plan for EMSC. For example, funding 
might be used to improve linkages between local and regional or State 
agencies, to develop pediatric standards for a region, or to assure 
effective field triage of the child in physical or emotional crisis to 
appropriate facilities and/or other resources. Activities implemented 
under prior EMSC program funding but not completed or made self-
sustaining during the original implementation project period will not 
be considered suitable. States that have previously received EMSC funds 
may apply for a system enhancement grant, as long as they will not also 
be receiving continuation funding for a State Systems grant during the 
project period of the systems enhancement grant. The range of funding 
for these grants is anticipated to be $100,000 to $150,000 for the 
first year, with grants of up to $100,000 for the second year.

Category (3): Targeted Issues Grants

    The third funding category is that of targeted issues grants on 
topics of importance to EMSC. These grants are intended to address 
specific, focused issues related to the development of EMSC capacity, 
with the potential to serve as national or regional models. Proposals 
in this category must have a well conceived methodology to evaluate the 
impact of the activity. The Director of the Maternal and Child Health 
Bureau (MCHB) will judge the acceptability of projects proposed in this 
category. Prospective applicants are urged to contact EMSC program 
staff well in advance of submitting their formal applications, so that 
the work of proposal development can be avoided if the proposed project 
is judged to be inappropriate for submission in this category.
    Applications are sought which will assist in meeting the objectives 
identified in the draft MCHB/NHTSA Five Year Plan for EMSC. Proposals 
should include a justification that clearly links the activities in the 
application with the plan's objectives.
    Up to five grants will be awarded in Category (3). States that have 
received EMSC funding as well as those that have never received EMSC 
funding may compete in this category. A total of $450,000 is allocated 
for this category for FY 1995. It is anticipated that the funding range 
will be $50,000 to $125,000 per award. Project periods are up to two 
years.

Category (4): Resource Capacity Cooperative Agreements

    Up to two resource centers will be supported through cooperative 
agreements under this funding category. These resource centers are 
intended to provide assistance in two areas: data use and linkage; and 
economics and health insurance/HMO issues. A total of $300,000 is 
allocated for this category for FY 1995. Project periods are up to two 
years.
    Area (A): Data Use and Linkage Cooperative Agreement Proposals are 
sought which assist States to identify, model, and organize data 
(including different data sets) so that outcomes for children and 
adolescents can be assessed in relation to various dependent variables. 
For example, States and grantees may want to link pre-hospital, 
emergency department, and hospital discharge data sets to identify 
problems in service delivery and the implications of these problems for 
treatment. Or, emergency department and pre-hospital data may be 
compared to determine use of pre-hospital transport by children or to 
assess injury morbidity in a community. Special activities of this 
center will include the following: (1) Identification of data sets for 
EMS that are currently available or under development (e.g., trauma 
registries, pre-hospital data sets, hospital discharge data, etc.); (2) 
identification of States that have adopted the Uniform Pre-Hospital EMS 
Minimum Data Set developed by NHTSA as well as other data sets and that 
use them to evaluate EMSC; (3) technical assistance to grantees and 
others in data systems management and linkage related to EMSC; (4) 
special statistical analyses on EMSC issues; (5) collaboration with 
national groups, including Federal agencies, in national data 
development planning to ensure inclusion of pediatric-related data 
elements, including those responsive to the special cultural and 
linguistic needs of specific populations. Plans for technical 
assistance to State systems grantees are a particularly critical 
component for proposals in this category.
    Area (B): Economics and Health Insurance/HMO Cooperative Agreement 
Proposals are sought which identify methods of providing technical 
assistance to States and to EMSC grantees on benefit/cost analyses, 
particularly those related to treatment and systems development issues 
affected by health insurer, HMO, and Federal or State Medicaid 
decisions, policies and protocols. Also important are analyses of how 
changes in insurance, HMO, or Medicaid policies may affect pediatric 
emergency care, and analyses of the impact on pediatric emergency care 
of differing reimbursement policies in contiguous jurisdictions.
    In addition to monitoring and technical assistance, Federal 
involvement will include the following:

--Making available the services of experienced MCHB personnel as 
participants in the planning and development of all phases of the 
project.
--Participation, as appropriate, in any conferences and meetings 
conducted during the period of the cooperative agreement.
--Review, approval, and implementation of procedures to be established 
for accomplishing the scope of work.
--Assistance and referral in the establishment of Federal interagency 
contacts that may be needed to carry out the project and assisting MCHB 
dissemination and program communication goals.
--Participation in the dissemination of project products.

    If time permits, comments from the public will be accepted on the 
categories, priorities, and preferences described above. Any comments 
which members of the public wish to make should be submitted to: Chief, 
Grants Management Branch, at the address in the ADDRESSES section.

Availability of Funds

    Approximately $10,000,000 is available for grants under the EMSC 
program, of which approximately $3,050,000 will be used for new grants. 
Of this total, the distribution of funds for new grants in FY 1995 is 
anticipated to be as follows:

 Emergency Medical Services for Children Grants, FY 1995 Award, Funding,
                     and Project Period Information                     
------------------------------------------------------------------------
                                     Max. No.      Est.                 
             Category                   of       amounts       Project  
                                     awards*    available*     period   
------------------------------------------------------------------------
(1) State Planning................          4     $200,000  1 year.     
(2) State Systems:                                                      
  (A) Implementation..............          6    1,500,000  2 years.    
  (B) System Enhancement..........          4      600,000  2 years.    
(3) Targeted Issues...............          4      450,000  2 years.    
(4) Resource Capacity.............          2      300,000  2 years.    
------------------------------------------------------------------------
*All grant amounts in this notice include indirect costs.               

Special Concerns

    The MCHB places special emphasis on improving service delivery to 
children from culturally identifiable populations who have been 
disproportionately affected by barriers to accessible care. This means 
that EMSC projects are expected to serve and appropriately involve in 
project activities members of ethnoculturally distinct groups, unless 
there are compelling programmatic or other justifications for not doing 
so. The MCHB's intent is to ensure that project outcomes are of benefit 
to culturally distinct populations and to ensure that the broadest 
possible representation of culturally distinct and historically under-
represented groups is supported through programs and projects sponsored 
by the MCHB. This same special emphasis applies to improving service 
delivery to children with special health care needs.

Project Review and Funding

    The Department will review applications in the preceding funding 
categories as competing applications and will fund those which, in the 
Department's view, are consistent with the statutory purpose of the 
program, with particular attention to children from culturally distinct 
populations and children with special health care needs; and that best 
meet the purposes of the EMSC program and address achievement of 
applicable Healthy People 2000 objectives related to emergency medical 
services and trauma systems.

Review Criteria

    The review of applications will take into consideration the 
following criteria:
     For Category (1) State Planning Grants:

--Evidence of the State's commitment to improve pediatric emergency 
care services and to continue with EMSC program implementation.
--The adequacy of the applicant's proposed method to identify problems 
and conduct a needs assessment.
--Evidence of the applicant's understanding of obstacles to EMSC 
activity in the past, and the completeness of proposed strategies to 
overcome these obstacles.
--The adequacy of the applicant's proposed planning process for 
improving EMSC.
--The soundness of the methods the applicant will use to: (1) Recruit, 
select and assemble appropriate participants, including minorities, 
with demonstrated expertise and experience in EMS; trauma systems; 
child health issues; and emergency care for children; and (2) obtain 
input from potential consumers (e.g., families) of a State EMSC plan.
--Reasonableness of the proposed budget, soundness of the arrangements 
for fiscal management, effectiveness of use of personnel, and 
likelihood of project completion within the proposed grant period.

     For Categories (2) State Systems Grants, and (3) Targeted 
Issues Grants:

--The adequacy of the applicant's understanding of the problem of 
pediatric trauma and critical illness in the grant locale, including 
the special problems of (a) children with special health care needs 
(CSHCN) and their families; and (b) minority children and families 
(including Native Americans, Native Hawaiians, and Alaska Natives).
--The appropriateness of project objectives and outcomes in relation to 
the specific nature of the problems identified by the applicant.
--In relation to the state of the art, the soundness, appropriateness, 
comprehensiveness, cost effectiveness, and responsiveness of the 
proposed methodology for achieving project goals and outcome 
objectives.
--The soundness of the plan for evaluating progress in achieving 
project objectives and outcomes.
--Reasonableness of the proposed budget, soundness of the arrangements 
for fiscal management, effectiveness of use of personnel, and 
likelihood of project completion within the proposed grant period.
--The extent to which the applicant will employ products and expertise 
of EMSC programs from other States, especially of current and former 
grantees of the Federal EMSC program.
--The extent to which the project gives special emphasis to the issues 
identified in the Special Concerns section of this notice.

     For Category (2) State Systems Grants only, the following 
additional criteria:

--The adequacy with which the applicant addresses institutionalization 
of the proposed project.
--The extent to which the applicant demonstrates collaboration and 
coordination with any trauma care systems implementation plan funded by 
HRSA.
--The extent to which the applicant demonstrates the involvement and 
participation of consumers (e.g., families) and parent advocacy groups 
in planning, needs assessment, and project implementation.
--The extent to which the applicant demonstrates a multi-disciplinary 
approach to EMSC system development, including providers at all levels 
(e.g., physicians, nurses, emergency medical technicians, social 
workers and others appropriate to project activities).
--Evidence that the applicant will collaborate and coordinate with 
other participants in the EMSC continuum, e.g., the State Emergency 
Medical Services agency; the State MCH/CSHCN agency or agencies; the 
State Highway Safety Office; other relevant State agencies; tribal 
nations; state and local professional organizations; private sector 
voluntary organizations; business organizations; hospital 
organizations; and any other ongoing federally-funded projects in EMS, 
injury prevention, and rural health.
--Adequacy of the applicant's plan to integrate pediatric emergency 
care into the primary care delivery system.

    For Category (3) Targeted Issues Grants only, the following 
additional criteria:

--The relevance of the proposed project to the draft MCHB/NHTSA Five 
Year Plan for EMSC.

     For Category (4) Resource Capacity Cooperative Agreements:

--The adequacy of the applicant's understanding of the issues being 
addressed in the proposal, including knowledge of and experience with 
strategies to overcome identified problems as well as familiarity and 
experience with the MCH Block Grant.
--The appropriateness of project objectives and outcomes in relation to 
the specific nature of the problems identified by the applicant.
--The soundness, appropriateness, comprehensiveness, cost effectiveness 
and responsiveness of the proposed methodology for achieving project 
goals and outcome objectives.
--The extent to which the proposed resources are necessary and 
sufficient for project activities.
--The soundness of the plan for evaluating progress in achieving 
project objectives and outcomes.
--The reasonableness of the proposed budget, soundness of the 
arrangements for fiscal management, effectiveness of use of personnel, 
and likelihood of project completion within the proposed grant period.
--The extent to which the applicant is capable of successfully carrying 
out the project, particularly, the qualifications of proposed staff.
--The extent to which the project gives special emphasis to the issues 
identified in the Special Concerns section of this notice.
--The soundness of the applicant's plan for linking and coordinating 
with the other EMSC resource centers.

Eligible Applicants

    Applications for funding will be accepted from States and 
accredited schools of medicine. Applications which involve more than a 
single State will also be accepted. In developing the proposed project, 
applicants must seek the participation and support of local or regional 
trauma centers and other interested entities within the State, such as 
local government and health and medical organizations in the private 
sector. If the applicant is a school of medicine, the application must 
be endorsed by the State. The State's endorsement must acknowledge that 
the applicant has consulted with the State and that the State is a 
participant in the proposed project.
    Any State (or medical school within that State) may apply for any 
category or subcategory of grant, subject to the following 
considerations based on equitable geographic distribution of EMSC 
funds, differences in purpose among EMSC grant categories, and 
variation among States in EMSC program progress:
     For Category (1) Planning Grants, States (or medical 
schools within those States) that have received prior EMSC 
implementation grants may not apply for planning grants.
     For Category (2)(A) Implementation Grants, applications 
from States (and medical schools within those States) that have not 
previously received EMSC program funds, or that have received only 
partial support under this program as part of a regional alliance, will 
receive preference for funding in this subcategory. This means that 
approved applications from States (and medical schools within those 
States) with no or very limited prior EMSC program support will be 
funded ahead of approved applications from outside this group.
     For Category (2)(B) System Enhancement Grants, States (and 
medical schools within States) that have previously received EMSC funds 
may apply for a system enhancement grant, as long as they will not also 
be receiving continuation funding for a State Systems Grant during the 
project period of the systems enhancement grant. States that have not 
previously received EMSC funds are advised to apply first for planning 
or implementation category funds.
     For Category (3) Targeted Issues Grants, eligibility is 
not affected by receipt of other EMSC funding.
     For Category (4) Resource Capacity Cooperative Agreements, 
eligibility is not affected by receipt of other EMSC funding.
    Applications will not be considered for both Category (1) State 
Planning Grants and Category (2)(A) Implementation Grants 
simultaneously from the same State. Funding of an application for a 
planning grant or for a State Implementation Grant bars a State from 
future competitions for that category or subcategory. Although funding 
of a Category (3) Targeted Issue Grant does not preclude a State (or 
medical school) from applying for other categories of EMSC funding, 
applicants should take care to avoid overlap in proposed project 
activities and associated Federal support for the separate categories.

Allowable Costs

    The MCHB may support reasonable and necessary costs of EMSC 
Demonstration Grant projects within the scope of approved projects. 
Allowable costs may include salaries, equipment and supplies, travel, 
contracts, consultants, and others, as well as indirect costs. The MCHB 
adheres to administrative standards reflected in the Code of Federal 
Regulations, 45 CFR Part 92 and 45 CFR Part 74.

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. (See Part 
148, Intergovernmental Review of PHS Programs under Executive Order 
12372 and 45 CFR Part 100 for a description of the review process and 
requirements).

    The OMB Catalog of Federal Domestic Assistance number is 93.127.

    Dated: December 9, 1994.
Ciro V. Sumaya,
Administrator
[FR Doc. 94-30760 Filed 12-14-94; 8:45 am]
BILLING CODE 4160-15-P