[Federal Register Volume 60, Number 140 (Friday, July 21, 1995)]
[Notices]
[Pages 37648-37651]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-18023]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[Announcement Number 543]


Cooperative Agreement for State Epidemiology and Laboratory 
Surveillance and Response

Introduction
    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1995 funds for a cooperative agreement 
program to ensure adequate capacity of local, State, and national 
efforts to conduct epidemiology and laboratory surveillance and 
response for infectious diseases.
    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 
priority area of

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Immunization and Infectious Diseases. (For ordering a copy of Healthy 
People 2000, see the section Where to Obtain Additional Information.)

Authority

    This program is authorized under Sections 301(a) [42 U.S.C. 241(a)] 
and 317 [42 U.S.C. 247b] of the Public Health Service Act, as amended. 
Applicable program regulations are found in 42 CFR Part 51b, Project 
Grants for Preventive Health Services and 42 CFR Part 52, Grants for 
Research Projects.

Smoke-Free Workplace

    PHS strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the non-use of all tobacco products, and 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities that receive Federal funds in which education, 
library, day care, health care, and early childhood development 
services are provided to children.

Eligible Applicants

    Eligible applicants are the official public health agencies of 
States or their bona fide agents. 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, the Republic of Palau, 
and federally recognized Indian tribal governments. In addition, 
official public health agencies of county or city governments with 
jurisdictional populations greater than 3,500,000 (based on 1990 census 
data) are eligible.

Availability of Funds

    Approximately $2,000,000 is available in FY 1995 to fund eight to 
twelve awards. It is expected that the average award will be 
approximately $170,000, ranging from $70,000 to $250,000. It is 
expected that the awards will begin on or about September 30, 1995, and 
will be made for a 12-month budget period within a project period of up 
to five years. Funding estimates may vary and are subject to change. 
Continuation awards within an approved project period will be made on 
the basis of satisfactory progress and availability of funds.

Purpose

    The purpose of this cooperative agreement is to assist State public 
health agencies in strengthening, maintaining, and enhancing capacity 
for public health surveillance and response for infectious diseases.
    Awards are intended to support the enhancement of existing basic 
surveillance and response capacity including the development and 
application of innovative surveillance approaches with a focus on 
notifiable diseases, foodborne and waterborne diseases, and drug- 
resistant infections.

Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient shall be responsible for addressing some or all of the 
activities under A., below, and CDC shall be responsible for conducting 
activities under B., below:

A. Recipient Activities

    1. Develop public health capacity for surveillance and response for 
infectious diseases, including flexible surveillance and response 
capability to meet the challenges of new and emerging infectious 
diseases.
    2. Implement public health surveillance and response measures for 
infectious diseases surveillance.
    3. Develop and apply innovations in public health surveillance and 
response for infectious diseases. Examples of such innovations include:
    a. Enhance rapid reporting of infectious diseases from clinical 
laboratories, such as electronic reporting of data already existing in 
clinical laboratory computer databases;
    b. Integrate laboratory-based and clinician-based surveillance 
information;
    c. Develop sentinel approaches for surveillance for certain 
infectious diseases;
    d. Develop relationships with managed care organizations to conduct 
infectious disease surveillance within their patient populations;
    e. Improve use of existing sources of information for infectious 
diseases surveillance, such as development of a system for surveillance 
of pneumonia through radiology records, or trends in emergency room 
visits for diarrhea or pneumonia; and
    f. Serve as a regional resource for State health laboratory 
activities in one or more specific areas, for example, serotyping of E. 
coli or subtyping of legionella from suspected outbreaks.
    4. Develop an approach for integrating surveillance information 
from the State epidemiology and laboratory units to improve early 
response and disease intervention activities.
    5. Develop and implement a plan to ensure that clinical 
laboratories submit isolates of designated organisms of public health 
importance to the State laboratory. Plans should be flexible enough to 
include new infectious disease problems such as those which occurred 
with Hantavirus, E. coli 0157:H7, and recent multidrug resistant 
organisms.
    6. Develop and implement long- and short-term training for 
epidemiology and laboratory staff that is consistent with the purpose 
of this agreement.
    7. Monitor and evaluate scientific and operational accomplishments 
and progress in achieving the purpose of this program.

B. CDC Activities

    1. Provide consultation and assistance in establishing enhanced 
reporting from laboratories and health care practitioners and in 
developing response capability.
    2. Assist in monitoring and evaluating scientific and operational 
accomplishments and progress in achieving the purpose of this program.
    3. Assist in supporting training activities for the development of 
epidemiology and laboratory staff in recipient States.

Evaluation Criteria

    The applications will be reviewed and evaluated according to the 
following weighted criteria:
    A. Understanding the objectives of the State Epidemiology and 
Laboratory Capacity Building Program: The extent to which the applicant 
demonstrates a clear understanding of the background and objectives of 
this program. (10 points)
    B. Description of area under surveillance: The extent to which the 
applicant clearly describes the following information for the State (or 
appropriate jurisdiction if applicant is a county, city, or other 
agency): demographic characteristics, population, geographic size, 
distribution of racial/ethnic minorities, and existing healthcare 
delivery systems for Medicaid and Medicare patients. (5 points)
    C. Description of existing public health infectious disease 
epidemiology and laboratory capacity. (15 points)
    1. Extent to which the applicant describes the scope of its 
existing surveillance and response activities in infectious diseases 
with respect to epidemiology and laboratory activities. Extent to which 
the applicant includes descriptions of reporting requirements, spectrum 
of laboratory specimen testing performed, degree of automation of 
laboratory and epidemiologic information management, and public health 
response capacity.
    2. Extent to which the applicant describes existing staffing, 
management, material and equipment investment, training, space, and 
financial support of

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laboratory and epidemiologic capacity for public health surveillance 
and response for infectious diseases.
    3. The extent to which the applicant:
    a. Describes collaboration between its existing epidemiology and 
laboratory programs in terms of laboratory-based surveillance and 
health care practitioner surveillance, including the existence of or 
potential for an integrated surveillance approach;
    b. Describes current or previous collaborative relationships with 
clinical laboratories, local health agencies, academic medicine groups, 
and health care practitioners, including HMOs or managed care 
providers;
    c. Demonstrates the potential of these relationships for enhanced 
surveillance and public health response activities; and
    d. Demonstrates an understanding of the interaction between public 
health, managed care, and the emerging health care delivery system.
    D. Identification of areas of need and potential areas for 
innovation in public health surveillance and response for infectious 
diseases:
    1. The extent to which the applicant identifies and describes needs 
in capacity (epidemiology and laboratory) for public health 
surveillance and response for infectious diseases. (25 points)
    2. The extent to which the applicant identifies potential areas for 
development and application of innovative approaches to surveillance 
and response for infectious diseases (15 points). Examples include, but 
are not limited to:
    a. Enhancement of rapid reporting of infectious disease from 
clinical laboratories for diseases in which such laboratories are an 
important source of surveillance information;
    b. Integration of laboratory-based and clinician- based 
surveillance information;
    c. Development of sentinel approaches for surveillance for certain 
infectious diseases;
    d. Development of relationships with managed care organizations to 
conduct infectious disease surveillance within their patient 
populations;
    e. Exploration of existing sources of data for infectious diseases 
surveillance (e.g., vital statistics, hospital discharge records, 
radiology records, insurance claims data, pharmacy records, and data 
from managed care organizations and HMOs); and
    f. Service as a regional resource for State health laboratory 
activities in one or more specific areas, for example, serotyping of E. 
coli or subtyping of legionella from suspected outbreaks.
    E. Operational Plan (25 points):
    1. The extent to which the applicant:
    a. Presents a plan for building capacity for public health 
surveillance and response for infectious diseases which clearly 
describes the proposed organizational and operating structure/
procedures, staffing plan, participating agencies, organizations, 
institutions, and key individuals;
    b. Describes plans for using the surveillance data to help 
implement public health responses; and
    c. Provides letters of support from participating agencies, 
institutions, and organizations indicating their willingness to 
participate in major surveillance and public health response 
initiatives.
    2. The extent to which the applicant's plan includes development 
and application of innovative approaches to surveillance and response 
for infectious diseases (examples of which are listed in paragraph D., 
above). The extent to which the applicant identifies specific important 
diseases or conditions (e.g., notifiable diseases, foodborne and 
waterborne diseases, and drug-resistant infections) which will be 
addressed. If applicant proposes to serve as a regional resource for 
State health laboratory activities, the extent to which the applicant 
specifies: (1) activities (e.g., providing regional testing for 
Hantavirus, or other infections or diseases) and (2) States that will 
be served (including letters of support from these States).
    3. The extent to which applicant's plan is consistent with, and 
adequate to achieve, the purpose and objectives of this program.
    F. The extent to which the applicant describes a detailed plan for 
monitoring and evaluation that will show the operational achievements 
and impact of the project. (5 points)
    G. The extent to which the proposed budget is reasonable, clearly 
justifiable, and consistent with the intended use of cooperative 
agreement funds. (Not Scored)

Executive Order 12372 Review

    Applications are subject to 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 (other than federally recognized 
Indian tribal governments) should contact their State Single Point of 
Contact(SPOC) 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 for each affected State. A 
current list of SPOCs is included in the application kit. Indian tribes 
are strongly encouraged to request tribal government review of the 
proposed application. If SPOCs or tribal governments have any process 
recommendations on applications submitted to CDC, they should forward 
them to Clara M. Jenkins, Grants Management Officer, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Mailstop E-18, Room 
314, Atlanta, Georgia 30305. The due date for State process 
recommendations is 30 days after the application deadline date for new 
and competing continuation awards. (A waiver for the 60 day requirement 
has been requested). The granting agency does not guarantee to 
``accommodate or explain'' for 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

    The Catalog of Federal Domestic Assistance Number is 93.283.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from ten or 
more individuals and funded by the cooperative agreement will be 
subject to review by the Office of Management and Budget (OMB) under 
the Paperwork Reduction Act.

Application Submission and Deadline

    The original and two copies of the application Form PHS-5161-1 
(Revised 7/92) must be submitted to Clara M. Jenkins, Grants Management 
Officer, Grants Management Branch, Procurement and Grants Office, 
Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry 
Road, NE., Room 314, Mailstop E-18, Atlanta, Georgia 30305, on or 
before August 21, 1995.
    1. Deadline: Applications shall 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

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Service postmark or obtain a legibly dated receipt from a commercial 
carrier or U.S. Postal Service. Private metered postmarks shall not be 
acceptable as proof of timely mailing.)
    2. Late Applications: Applications which 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 and information on application 
procedures are contained in the application package. Business 
management technical assistance may be obtained from Gordon R. Clapp, 
Grants Management Specialist, Grants Management Branch, Procurement and 
Grants Office, Centers for Disease Control and Prevention (CDC), 255 
East Paces Ferry Road, NE., Room 314, Mailstop E-18, Atlanta, Georgia 
30305, telephone (404) 842-6508.
    Programmatic technical assistance may be obtained from Pat 
McConnon, National Center for Infectious Diseases, Centers for Disease 
Control and Prevention (CDC), Mailstop C-12, 1600 Clifton Road, NE., 
Atlanta, Georgia 30333, telephone (404) 639-2175, Email Address: 
[email protected].
    Please refer to Announcement Number 543 when requesting information 
regarding this program.
    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) referenced in the Introduction 
through the Superintendent of Documents, Government Printing Office, 
Washington, DC 20402-9325, telephone (202) 512-1800.

    Dated: July 17, 1995.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 95-18023 Filed 7-20-95; 8:45 am]
BILLING CODE 4163-18-P