[Federal Register Volume 61, Number 58 (Monday, March 25, 1996)]
[Notices]
[Pages 12076-12083]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-7106]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration


Special Project Grants and Cooperative Agreements; Maternal and 
Child Health Services; Federal Set-Aside Program; Comprehensive 
Hemophilia Centers, Genetic Services, and Maternal and Child Health 
Improvement Projects

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

ACTION: Notice of availability of funds.

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SUMMARY: The HRSA announces that applications will be accepted for 
fiscal year (FY) 1996 funds for grants and cooperative agreements for 
the following activities: Maternal and Child Health (MCH) Special 
Projects of Regional and National Significance (SPRANS), including 
comprehensive hemophilia diagnostic and treatment centers; genetic 
disease testing, counseling and information services; and special MCH 
improvement projects (MCHIP) which contribute to the health of mothers, 
children, and children with special health care needs (CSHCN). All 
awards will be made under the program authority of section 502(a) of 
the Social Security Act, the MCH Federal Set-Aside Program. A revised 
regulation implementing the Federal Set-Aside Program (42 CFR part 51a) 
was published in the July 19, 1994, issue of the Federal Register at 59 
FR 36703. Within the HRSA, SPRANS grants are administered by the 
Maternal and Child Health Bureau (MCHB). Awards are made for grant 
periods which generally run from 1 up to 5 years in duration. Grants 
for SPRANS research and training are being announced in a separate 
notice.
    This program announcement is subject to the appropriation of funds. 
Applicants are advised that this program announcement is a contingency 
action being taken to assure that should funds become available for 
this purpose, they can be awarded in a timely fashion consistent with 
the needs of the program as well as to provide for even distribution of 
funds throughout the fiscal year. At this time, given a continuing 
resolution and the absence of FY 1996 appropriations for the MCH 
Federal Set-Aside Program, the amount

[[Page 12077]]
of available funding for this specific grant program cannot be 
estimated.
    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 for setting priority areas. The MCH 
Block Grant Federal Set-Aside Program addresses issues related to the 
Healthy People 2000 objectives of improving maternal, infant, child and 
adolescent health and developing service systems for children with 
special health care needs. 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 PHS strongly encourages all grant recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products. 
In addition, Public Law 103-227, the Pro-Children Act of 1994, 
prohibits smoking in certain facilities (or in some cases, any portion 
of a facility) in which regular or routine education, library, day 
care, health care or early childhood development services are provided 
to children.

ADDRESSES: Grant applications for MCH SPRANS hemophilia, genetics, and 
MCHIP grants must be obtained from and submitted to: Chief, Grants 
Management Branch, Office of Operations and Management, Maternal and 
Child Health Bureau, Health Resources and Services Administration, Room 
18-12, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, 
(301) 443-1440. Applicants will use revised PHS form #5161-1, approved 
by the Office of Management and Budget (OMB) under control number 0937-
0189. You must obtain application materials in the mail. Written 
requests should specify the category or categories of activities for 
which an application is requested so that the appropriate materials may 
be provided.
    Federal Register notices and application guidance for MCHB programs 
are available on the World Wide Web via the Internet at address: http:/
/www.os.dhhs.gov/hrsa/mchb. Click on the file name you want to download 
to your computer. It will be saved as a self-extracting (Macintosh or) 
Wordperfect 5.1 file. To decompress the file once it is downloaded, 
type in the file name followed by a . The file will expand to a 
Wordperfect 5.1 file. If you have difficulty accessing the MCHB Home 
Page via the Internet and need technical assistance, please contact 
Linda L. Schneider at 301-443-0767 or ``[email protected]''.

DATES: Potential applicants are invited to request application packages 
for the specific program category in which they are interested, and to 
submit their applications for funding consideration. Deadlines for 
receipt of applications differ for the several categories of grants. 
These deadlines may be found in Section 5, below, for each category 
covered by this notice.
    Applications will be considered to 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 the contact persons identified below 
for each category covered by this notice. Requests for information 
concerning business management issues should be directed to: Acting 
Grants Management Officer (GMO), MCHB, at the address specified in the 
ADDRESS section.

SUPPLEMENTARY INFORMATION: To facilitate the use of this announcement, 
information in this section has been organized, as outlined in the 
Table of Contents below, into a discussion of: Program Background, 
Special Concerns, Evaluation Protocol, Project Review and Funding, 
SPRANS Project Grants, Public Comment, Eligible Applicants, and Public 
Health System Reporting Requirements. In addition, for each research 
and training funding category or subcategory, information is presented 
under the following headings:
     Application Deadline.
     Purpose.
     Priorities.
     Special Eligibility Considerations.
     Project Period.
     Contact.

Table of Contents

1. Program Background and Objectives
2. Special Concerns
3. Evaluation Protocol
4. Project Review and Funding
    4.1. Criteria for Review
    4.2. Funding of Approved Applications
5. Special Projects of Regional and National Significance
    5.1. Grants
    5.1.1. Comprehensive Hemophilia Diagnostic and Treatment
    5.1.2. Genetic Disease Testing, Counseling and Information
    5.1.3. Maternal and Child Health Improvement Projects
    5.1.3.1. State Systems Development Initiative
    5.1.3.2. Transition Services in Adolescent Health
    5.1.3.3. Universal Newborn Hearing Screening
    5.1.3.4. Data Utilization and Enhancement
    5.1.3.5. Healthy Tomorrows Partnerships for Children
    5.2. Cooperative Agreements
    5.2.1. Maternal and Child Health Providers Partnership
    5.2.2. Partnership for Information and Communication
    5.2.3. Fetal/Infant Mortality Review Program Support Center
    5.2.4. Partnership for Adolescent Health
6. Public Comment
7. Eligible Applicants
8. Public Health System Reporting Requirements
9. Executive Order 12372

1. Program Background and Objectives

    Under Section 502 of the Social Security Act, as amended by the 
Omnibus Budget Reconciliation Act (OBRA) of 1989, 12.75 percent of 
amounts appropriated for the MCH Block Grant in excess of $600 million 
are set aside by the Secretary of Health and Human Services (HHS) for 
special Community Integrated Service Systems projects under Section 
501(a)(3) of the Act. Of the remainder of the total appropriation, 15 
percent of the funds are to be retained by the Secretary to support 
(through grants, contracts, or otherwise) special projects of regional 
and national significance, research, and training with respect to 
maternal and child health and children with special health care needs 
(including early intervention training and services development); for 
genetic disease testing, counseling, and information development and 
dissemination programs; for grants (including funding for comprehensive 
hemophilia diagnostic treatment centers) relating to hemophilia without 
regard to age; and for the screening of newborns for sickle cell 
anemia, and other genetic disorders and follow-up services. The MCH 
SPRANS set-aside was established in 1981. Support for projects covered 
by this announcement will come from the SPRANS set-aside. Applications 
for FY 1996 funds for MCH research and training grants are being 
solicited separately from other SPRANS grants this year in order to 
reduce confusion to potential applicants from

[[Page 12078]]
announcement of grants in very large numbers of SPRANS categories and 
subcategories.

2. Special Concerns

    In its administration of the MCH Services Block Grant, the MCHB 
places special emphasis on improving service delivery to women and 
children from racial and ethnic minority populations who have had 
limited access to accessible care. This means that SPRANS projects are 
expected to serve and appropriately involve in project activities 
individuals from the populations to be served, unless there are 
compelling programmatic or other justifications for not doing so. The 
MCHB's intent is to ensure that project interventions are responsive to 
the cultural and linguistic needs of special populations, that services 
are accessible to consumers, and that the broadest possible 
representation of culturally distinct and historically underrepresented 
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.
    In keeping with the goals of advancing the development of human 
potential, strengthening the Nation's capacity to provide high quality 
education by broadening participation in MCHB programs of institutions 
that may have perspectives uniquely reflecting the Nation's cultural 
and linguistic diversity, and increasing opportunities for all 
Americans to participate in and benefit from Federal public health 
programs, HRSA will place a funding priority on projects from 
Historically Black Colleges and Universities (HBCU) or Hispanic Serving 
Institutions (HSI) in all categories and subcategories in this notice 
for which applications from academic institutions are encouraged. This 
is in conformity with the Federal Government's policies in support of 
White House Initiatives on Historically Black Colleges and Universities 
(Executive Order 12876) and Educational Excellence for Hispanic 
Americans (Executive Order 12900). An approved proposal from a HBCU or 
HSI will receive a 0.5 point favorable adjustment of the priority score 
in a 4 point range before funding decisions are made.

3. Evaluation Protocol

    With the exception of SPRANS hemophilia projects--which have an 
alternative assessment mechanism in place--an MCH discretionary grant 
project, including a SPRANS, is expected to incorporate a carefully 
designed and well planned evaluation protocol capable of demonstrating 
and documenting measurable progress toward achieving the project's 
stated goals. The protocol should be based on a clear rationale 
relating the grant activities, the project goals, and the evaluation 
measures. Wherever possible, the measurements of progress toward goals 
should focus on health outcome indicators, rather than on intermediate 
measures such as process or outputs. A project lacking a complete and 
well-conceived evaluation protocol as part of the planned activities 
will not be funded.

4. Project Review and Funding

    Within the limit of funds determined by the Secretary to be 
available for the activities described in this announcement, the 
Secretary will review applications for funds under the specific project 
categories in section 4, below, as competing applications and may award 
Federal funding for projects which will, in her judgment, best promote 
the purpose of title V of the Social Security Act, with special 
emphasis on improving service delivery to women and children from 
culturally distinct populations; best address achievement of Healthy 
Children 2000 objectives related to maternal, infant, child and 
adolescent health and service systems for children at risk of chronic 
and disabling conditions; and otherwise best promote improvements in 
maternal and child health.

4.1  Criteria for Review

    The criteria which follow are used, as pertinent, to review and 
evaluate applications for awards under all SPRANS grants and 
cooperative agreement project categories announced in this notice. 
Further guidance in this regard is supplied in application guidance 
materials, which may specify other criteria.

--The quality of the project plan or methodology.
--The need for the research or training.
--The extent to which the project will contribute to the advancement of 
maternal and child health and/or improvement of the health of children 
with special health care needs.
--The extent to which the project is responsive to policy concerns 
applicable to MCH grants and to program objectives, requirements, 
priorities and/or review criteria for specific project categories, as 
published in program announcements or guidance materials.
--The extent to which the estimated cost to the Government of the 
project is reasonable, considering the anticipated results.
--The extent to which the project personnel are well qualified by 
training and/or experience for their roles in the project and the 
applicant organization has adequate facilities and personnel.
--The extent to which, insofar as practicable, the proposed activities, 
if well executed, are capable of attaining project objectives.
--The strength of the project's plans for evaluation.
--The extent to which the project will be integrated with the 
administration of the MCH Block Grant, State primary care plans, public 
health, and prevention programs, and other related programs in the 
respective State(s).
--The extent to which the application is responsive to the special 
concerns and program priorities specified in this notice.

4.2  Funding of Approved Applications

    Final funding decisions for SPRANS grants are the responsibility of 
the Director, MCHB. In considering scores for the ranking of approved 
applications for funding, preferences may be exercised for groups of 
applications; for example, new projects may be funded ahead of 
competing continuations, or vice versa. Within any category of approved 
projects, the score of an individual project may be favorably adjusted, 
as noted in the notice or in guidance for that category, if the project 
addresses specific identified priorities. In addition, special 
consideration in assigning scores may be given by reviewers to 
individual applications that address areas identified in this notice as 
special concerns.

5. Special Projects of Regional and National Significance

    Three categories of SPRANS grants are discussed below: 
Comprehensive Hemophilia Diagnostic and Treatment Centers; Genetic 
Disease Testing, Counseling and Information; and Maternal and Child 
Health Improvement Projects.

5.1  Grants

    Three major categories of SPRANS grants are discussed below: 
Comprehensive Hemophilia Diagnostic and Treatment Centers; Genetic 
Disease Testing, Counseling and Information; and Maternal and Child 
Health Improvement Projects (in 5 sub-categories):

[[Page 12079]]

5.1.1.  Comprehensive Hemophilia Diagnostic and Treatment Centers
     Application Deadline: June 17, 1996.
     Purpose: To provide comprehensive hemophilia diagnostic 
and treatment services to individuals with hemophilia and other 
congenital bleeding disorders through a regional network of 
approximately 140 comprehensive hemophilia diagnostic and treatment 
centers and for regional coordination.
     Priorities: The following overall program goals are 
priorities; to be eligible for consideration, proposals must address 
all of these:

--Access to comprehensive care for hemophilia and HIV as described in 
``Standards and Criteria for the Care of Persons with Congenital 
Bleeding Disorders'' as published by the National Hemophilia Foundation 
(NHF).
--Fostering development of comprehensive care systems that provide 
culturally sensitive, family-centered care, coordinated through a 
regional system of hemophilia diagnostic and treatment centers.
--Outreach and increased access to comprehensive care, especially to 
the underserved and minorities.
--Emphasis on prevention to reduce complications and morbidity 
associated with hemophilia.
--Provision of services to women with congenital bleeding disorders.
--Collaboration and coordination of services with State Title V 
Maternal and Child Health programs; Ryan White Titles I, II, and III; 
community based organizations; State and local health agencies; Ryan 
White Title IV Pediatric HIV projects funded by the MCHB; and education 
and peer support activities of the NHF, such as Men's Advocacy Network 
of NHF (MANN), Women's Outreach Network of NHF (WONN) and Chapter 
Outreach Development Program (CODP); and with the Centers for Disease 
Control and Prevention (CDC) regarding the provision of HIV prevention, 
risk reduction, and counseling services, especially those targeted to 
adolescents and their sexual partners.
--Evidence of formal patient choice and grievance policies and 
procedures.

    Preference for funding will be given to existing MCHB-supported 
comprehensive hemophilia diagnostic and treatment centers that have 
demonstrated high performance in development and coordination of 
regional services.
     Project Period: The project period is 3 years.
     Contact: For programmatic or technical information, 
contact Patrick McGuckin, on (301) 443-9051.
5.1.2.  Genetic Disease Testing, Counseling and Information
     Application deadline: April 29, 1996.
     Purpose: To support projects that demonstrate increased 
access to effective genetic information, education, testing, and 
counseling services.
     Priorities: Applicants are invited to submit proposals to 
broaden access to genetic services through the following:

--A council of regional networks for genetic services. To coordinate 
activities and facilitate collaboration of ten regional genetic 
services networks supported by MCHB, and to address issues of genetic 
services in public health programs at the national level.
--Four regional genetic services networks. To develop and maintain 
infrastructures for genetic services in the Midwest/Great Plains, Mid-
Atlantic, New England, and Southeast regions of the United States.
--An alliance of genetic support groups. To maintain a national 
coalition of genetics support groups, consumers, and professionals to 
improve responsiveness of genetic services to concerns of individuals 
and families affected by genetic disorders.

    Preference for funding will be given to existing MCHB-supported 
comprehensive genetic projects that have demonstrated high performance 
in fulfilling the above priorities.
     Project Period: Project periods are up to 3 years.
     Contact: For programmatic or technical information, 
contact Jane S. Lin-Fu, M.D., telephone 301/443-1080.
5.1.3.  Maternal and Child Health Improvement Projects
    Maternal and Child Health Improvement Projects (MCHIP) are divided 
into five subcategories: State Systems Development Initiative; 
Transition Services in Adolescent Health; Universal Newborn Hearing 
Screening; Data Utilization and Enhancement; and Healthy Tomorrows 
Partnerships for Children
    5.1.3.1. State Systems Development Initiative.
    Application Deadline: July 15, 1996.
    Purpose: To assist State Agency Maternal and Child Health and 
Children with Special Health Care Need programs in the development of a 
State and community infrastructure that results in comprehensive, 
community-based systems of care for all children and their families. 
Projects must: (1) support systems development activities identified in 
the Title V MCH Block Grant application; (2) collaborate with CISS, 
Healthy Start, and the Primary Care Cooperative Agreement; (3) 
collaborate with other system development initiatives, such as, mental 
health and education; (4) build on systems already in place; (5) and 
make an effort to sustain systems development activities in the Title V 
agency.
    Priorities: Priority for funding will be given to projects in the 
following areas:

--Establishing an integrated data management system which meets user 
needs at the local, State, and national levels and is electronically 
accessible.
--Supporting community-level planning for establishing priorities, 
policies, and strategies for systems development.
--Improving collaborative partnerships for integrating health services.
--Initiating collaborative partnerships for integrating health with 
other services, e.g., education, mental health, and social services.
--Promoting service systems that are family-centered and culturally 
competent.
--Developing a mechanism for assuring quality performance and 
utilization of community systems.
--Strengthening the skills, knowledge, and ability of state and 
community leaders to develop comprehensive community systems of care.

    Special Eligibility Considerations: Eligibility for funding is 
limited to the Title V agencies in the 50 States and 9 Jurisdictions.
    Project Period: Three years.
    Contact: Kay K. Guirl, R.N., M.N., Senior Public Health Analyst, 
Division of Services for Children with Special Health Needs, 301 443-
2350.
    5.1.3.2. Transition Services in Adolescent Health.
     Application Deadline: May 15, 1996.
     Purpose: To fund two categories of SPRANS projects which 
support ongoing efforts to develop comprehensive, culturally competent, 
community-based, family-centered, coordinated care systems for 
adolescents with special health care needs and their families. The 
funds are intended to help these adolescents achieve a successful 
transition to community-based, comprehensive care and to maximize 
potential for employment. The MCHB has identified the need for public 
and private partnerships to improve the coordination of services to 
assist and

[[Page 12080]]
support adolescents with disabilities. These efforts are based, in 
part, on the work of the Federal SSI/CSHCN Workgroup, a collaborative 
effort of the MCHB, the Social Security Administration (SSA), and State 
Title V CSHCN Programs, which has identified barriers faced by 
adolescents with special health needs; and the National Commission on 
Childhood Disability, which, in its October, 1995, Report to Congress, 
identified changes needed in the SSI Program to more effectively 
promote self sufficiency of SSI child beneficiaries.
    Another excellent example of ongoing collaboration, the CHOICES 
Project is a public/private partnership jointly funded by the MCHB and 
the Shriners Hospitals. CHOICES has strengthened cooperation between 
Title V CSNCN programs, Shriners Hospitals, and Vocational 
Rehabilitation programs and maximized services available to adolescents 
with disabilities. The MCHB is seeking to build on the past efforts of 
CHOICES, to strengthen systems of care for adolescents and 
preadolescents with special health needs and encourage them to grow, 
develop and make a successful transition to comprehensive care, work 
and self sufficiency. Utilizing the resources of a broad spectrum of 
health and social services providers, vocational training and 
rehabilitation agencies, education and private employers, the 
initiative will: (1) Identify and increase the understanding of the 
needs and special problems of adolescents with disabilities in making 
successful transitions to adult care, to be ``healthy and ready to 
work'' and to achieve self sufficiency; (2) foster the development of 
public and private partnerships and collaborative relationships that 
will maximize the availability of and access to comprehensive, 
community-based, coordinated care systems for adolescents with special 
health needs and their families; and (3) improve the ability of 
adolescents with disabilities to lead productive lives and maximize 
financial independence.
     Priorities/Funding Categories: Applications are being 
accepted for two categories of projects in FY 1996. Applications which 
do not fall within these program categories will not be considered.

--The Priority 1 funding category will support community-based planning 
and initial development grants to strengthen community-based systems 
that help adolescents with disabilities make successful transitions to 
self sufficiency and work. The emphasis of this category is on support 
for community level infrastructures of agencies, providers, community 
organizations, business and families. Projects will focus on needs 
assessment and local capacity-building, identifying and making maximum 
use of all available public and private resources for reaching and 
providing services to the target population. Services to transition 
adolescents from child-centered to adult-based care are expected to 
include primary, preventive, and specialty care that also addresses 
psychosocial needs. Projects must involve targeted adolescents and 
their families in needs assessment, as well as ongoing project planning 
and development. Funding will support local capacity building for 
planning, coordination of services, and care and financing systems 
development. Collaboration must be evident with key public programs 
within the community responsible for serving adolescents with special 
needs and disabilities funded under Title V Maternal and Child Health 
programs, vocational rehabilitation, education, mental health, social 
services agencies, and the State's SSI Action Plan.
--The Priority 2 funding category will expand already established 
regional and/or national efforts to support adolescents in making 
successful transitions from hospital to ambulatory care, to be 
``healthy and ready to work'' and to achieve independence. Priority 2 
projects will have the same general goals as those defined in Priority 
1; however Priority 2 applicants must have already completed planning 
and initial development and have an existing infrastructure to achieve 
project goals and objectives. This infrastructure must, at a minimum, 
include selected State Title V CSHCN programs, Shriners Hospitals, and 
Vocational Rehabilitation programs. Applicants must represent a public/
private partnership of Title V and a national hospital network which 
serves significant numbers of adolescents with disabilities. In 
addressing the goal of preparing adolescents to make transitions to 
adult comprehensive care and independent living, the project must 
involve community resources, including Vocational Rehabilitation, 
education, and employers in order to identify appropriate work 
opportunities and assure that adolescents have ongoing comprehensive 
and coordinated health care coverage.

     Special Eligibility Considerations: In keeping with the 
September 15, 1995, report of the U.S. Senate Appropriations Committee 
(S. Rep. 104-145), which urged continued MCHB support for the CHOICES 
Project, special preference for Priority 2 grants will be given to 
projects of similar scope and organization.
     Project Period: One to two year awards for Priority 1 
projects; one to three years for Priority 2 projects.
     Contact: For programmatic or technical information, 
contact Beth D. Roy, telephone 301 443-2370. A pre-application 
conference call will be held on Thursday, April 18, at 2:00 p.m., EST. 
Persons interested in participating should send a letter of interest, 
including a brief description of their proposal and any issues they 
wish to have addressed during the call, by Friday, April 5, to Beth 
Roy, Room 18A-27, Parklawn Building, 5600 Fishers Lane, Rockville, MD 
20857.
    5.1.3.3. Universal Newborn Hearing Screening.
     Application Deadline: May 17, 1996.
     Purpose: To promote the establishment of statewide 
universal newborn hearing screening programs in the United States 
through a national network which (a) increases awareness of the 
feasibility of newborn hearing screening, (b) provides technical 
assistance on program establishment, maintenance, and coordination, and 
(c) maintains and analyzes data to monitor and evaluate the impact of 
universal newborn hearing screening programs. This priority responds to 
the Healthy People 2000 objective (17.16) which calls for the reduction 
in the average age at which children with significant hearing 
impairment are identified to no more than 12 months.
     Priorities: Priority for funding will be given to those 
applications which address the following factors:

--Coordination of screening programs emphasizing linkages between 
hospital screening programs, pediatricians, audiologists, state 
agencies, and community services providers.
--Sustainability beyond the grant period emphasizing utilization of 
local funding to establish and institutionalize programs as part of the 
ongoing provision of health care services.
--Ongoing support and technical assistance for emerging programs 
utilizing valid, cost effective, and feasible strategies and 
instrumentation for the conduct of universal hearing screening.
--Impact of early screening, emphasizing outcome evaluation

[[Page 12081]]
which includes both quantitative and qualitative data on 
identification, intervention, cost, and developmental outcomes for 
young children.

      Project Period: The project period is four years.
     Contact: For programmatic or technical information, 
contact Bonnie Strickland, Ph.D., 301/443-1080.
    4.1.3.4. Data Utilization and Enhancement.
     Application Deadline: June 17, 1996.
     Purpose: To enhance the use of information and information 
technologies within State and local MCH/CSHCN agencies and within the 
MCH community in the development of policies, programs and evaluation 
of services to improve the health and well being of mothers and all 
children as outlined in the ``MCH Strategy Statement: Data Systems and 
Enhancement.'' Activities in this initiative may include:

--Development of retrievable and usable information and model data 
systems. The systems will be used in the collection, management, and 
analysis of data to facilitate needs assessment, planning, program 
implementation, monitoring, and evaluation of the health status of 
mothers and children and the delivery of comprehensive health care to 
that population.
--Linkage of and/or improvement of access to information among various 
service and data systems. These may include administrative, clinical, 
educational, communities and population information.
--Analysis of economic cost, benefits and effectiveness of services and 
systems on the well being of the MCH community, particularly the high 
risk and underserved portions of the population, including a 
compilation of service cost impacts related to health outcomes, cost 
benefit analysis of major MCH services, and dissemination of economic 
information to the MCH community.

    Work products may take a variety of forms, such as papers, models, 
software, information services, stipends, and reports. Work products 
will be directed to the MCH community, including all mothers and 
children, and the service and system providers integral to providing 
them with comprehensive, family centered, culturally competent, 
community services.
     Priorities: Proposals in this MCHIP subcategory are 
invited in the following program areas:

--Development of model information systems with data that can be 
retrieved, integrated, and used by others at national and State levels.
--Enhancement of information collection and analysis capabilities of 
national, State and local health agencies using the models developed, 
training, and peer consultation.
--Collection, management, and analysis of data, and development and 
application of analytic and information management techniques focusing 
on national MCH issues.
--Networking, coordination, and integration of existing and proposed 
resources and data information technologies and analysis systems 
developed by other States or organizations.
--Increasing national, State and local analytical and information 
system capacity to respond to and implement changes in the organization 
of health care resources.
--Dissemination of relevant programmatic and population information and 
developed models to enhance access and utility for the MCH populations.
--Provision of direction and incentives to individuals in carrying out 
the purpose of this initiative through partnerships with educational 
institutions and State and local MCH agencies.
--Monitoring and assessing information and information technology 
requirements parallel to organizational changes in delivery of health 
care services to all mother and children.

     Grants/Amounts: Up to 3 years, with declining Federal 
funding and escalating local funding.
     Contact: For programmatic or technical information, 
contact Russ Scarato, telephone: 301 443-8041.
    5.1.3.5. Healthy Tomorrows Partnerships for Children.
     Application Deadline: May 13, 1996.
     Purpose: To support projects for mothers and children that 
improve access to health services and utilize preventive strategies. 
The initiative encourages additional support from the private sector 
and from foundations to form community-based partnerships to coordinate 
health resources for pregnant women, infants and children.
     Priorities: Proposals in this MCHIP category are invited 
in the following program areas:

--Local initiatives that are community-based, family-centered, 
comprehensive and culturally relevant and improve access to health 
services for infants, children, adolescents, or CSHCN.
--Initiatives which show evidence of a capability to meet cost 
participation goals by securing funds for the second and sequential 
years of the project.

     Special Eligibility Considerations: In the interest of 
equitable geographic distribution, special consideration for funding 
will be given to projects from States without a currently funded 
project in this category. These States are cited in the application 
guidance.
     Project Period: Five years.
     Contact: For programmatic or technical information, 
contact Latricia Robertson, M.S.N., M.P.H., telephone: 301 443-8041.

5.2. Cooperative Agreements

    Cooperative agreements will be awarded in four categories: Maternal 
and Child Health Providers Partnership; Partnership for Information and 
Communication; Fetal/Infant Mortality Review Program Support Center; 
and Partnership for Adolescent Health.
    There will be substantial Federal programmatic involvement in these 
cooperative agreements. This means that after award, awarding office 
staff provide technical assistance and guidance to, or coordinate and 
participate in, certain programmatic activities of award recipients 
beyond their normal stewardship responsibilities in the administration 
of grants. Federal involvement may include, but is not limited to, 
planning, guidance, coordination and participation in programmatic 
activities. Periodic meetings, conferences, and/or communications with 
the award recipient are held to review mutually agreed upon goals and 
objectives and to assess progress. Additional details on the scope of 
Federal programmatic involvement in cooperative agreements, consistent 
with HRSA grants administration policy, will be included in the 
application guidance for these cooperative agreements.
5.2.1. Maternal and Child Health Providers Partnership
     Application Deadline: June 1, 1996.
     Purpose: To support activities which improve access and 
the delivery of maternal and child health services through governmental 
and professional partnerships. Specifically, the program is designed to 
promote problem-solving approaches which enhance community and provider 
participation. This provider partnership will encourage private sector 
and other support for improved coordination of and access to health 
resources at the community-level for pregnant women, infants and 
children.

[[Page 12082]]

    Any national membership organization able to demonstrate that it 
represents a group(s) of providers of pediatric services will be 
considered for funding.
    Specific program requirements include:

--Analysis of the obstacles (issues and contributing factors) to 
provider participation in the delivery of maternal and child health 
services to low-income pregnant women and children, as well as 
involvement in problem solving at the community level.
--Development of strategies to improve maternal and child health status 
and systems through collaboration with the Federal MCHB which promote 
problem solving at the community level; encourage provider 
participation; and encourage private sector and other support for 
improved coordination of and access to health resources at the 
community level.
--Dissemination and effective communication of concerns and information 
pertaining to the issues and strategies employed to their members and 
other national organizations.

     Project Period: Up to 5 years.
     Contact: For programmatic or technical information, 
contact Latricia Robertson, M.S.N., M.P.H., telephone: 301-443-8041.
5.2.2. Partnership for Information and Communication (PIC)
     Application Deadline: June 15, 1996.
     Purpose: To facilitate dissemination of new maternal and 
child health-related information to policy and decision makers in a 
format most useful to them and provide those individuals with a means 
of communicating issues directly to each other and to MCHB. This is a 
continuous Bureau activity with a single priority--to enhance 
communication between the MCHB and governmental, professional and 
private organizations representing leaders and policy makers concerned 
with issues related to maternal and child health. Organizations 
currently receiving support as part of this cooperative agreement 
represent State governors and their staffs; State Title V programs; 
State legislators; private business, particularly self-insured 
businesses; philanthropic organizations; and parent organizations, as 
well as national membership organizations representing groups or 
constituencies listed below.
    To ensure continuity, membership for the organizations 
participating in PIC is rotated so that not all project periods 
coincide. For this year, only national membership organizations 
representing the following groups will be considered for funding:

--County health policymakers.
--Municipal health policymakers.

     Project Period: Up to 5 years.
     Contact: For programmatic or technical information, 
contact David Heppel, M.D., telephone: 301-443-2250.
5.2.3. Fetal/Infant Mortality Review Program Support Center
     Application Deadline: June 14, 1996.
     Purpose: To provide technical support to States and 
communities as they develop and implement community-based fetal/infant 
mortality review process. Fetal/Infant Mortality Review (F/IMR) is a 
process that identifies, through use of a community multidisciplinary 
team, community health care system, economic and social factors that 
may have contributed to an infant death. These findings are then used 
by the community to address the identified contributing factors and to 
promote local program development.
    The Center will be responsible for working with the MCHB to promote 
the F/IMR process, provide assistance in setting up the process, share 
pertinent information among communities and States, develop refinements 
and new approaches to the F/IMR process to make it more responsive and 
efficient, and expand the use of this problem-solving to other 
mortality and morbidity events impacting the MCH population.
     Project Period: Up to five years.
     Contact: For programmatic or technical information, 
contact David Heppel, M.D., telephone: 301-443-2250.
5.2.4. Partnership for Adolescent Health
     Application Deadline: June 14, 1996.
    Purpose: To collaborate with membership organizations having an 
historic interest in adolescent health in seeking policy guidance from 
and providing programmatic information to their memberships. This 
cooperative agreement stems from Congress's mandate to the Department, 
in section 1708 of the Public Health Service Act, to create an Office 
of Adolescent Health (OAH). The functions of the OAH are delegated to 
the MCHB. Fulfilling the need for a focal point for adolescent health, 
the OAH is responsible for assisting private and other public 
organizations to develop a collaborative approach to planning, 
implementing, monitoring and evaluating national programs to promote, 
improve and maintain the health status of pre-adolescents and 
adolescents.
    Priorities: For purposes of this competition, only membership 
organizations representing the following disciplines will be considered 
for funding:

--Law.
--Social Work.
--Psychology.
--Medicine.

    Future competitions will be focused on other professional 
disciplines.
    Project Period: Up to 5 years.
    Contact: For programmatic or technical information contact Juanita 
C. Evans, LCSW, telephone: 301 443-4026.

6. Public Comment

    The categories, priorities, special considerations and preferences 
described above are not being proposed for public comment this year. In 
July 1993, following publication of the Department's Notice of Proposed 
Rulemaking to revise the MCH special project grant regulations at 42 
CFR part 51a, the public was invited for a 60-day period to submit 
comments regarding all aspects of the SPRANS application and review 
process. In responding to those comments, the Department noted the 
practical limits on Secretarial discretion in establishing SPRANS 
categories and priorities owing to the extensive prescription in both 
the statute and annual Congressional directives.
    Comments on this SPRANS notice which members of the public wish to 
make are welcome at any time and may be submitted to: Director, MCHB, 
at the address listed in the ADDRESS section. Suggestions will be 
considered when priorities are developed for the next solicitation.

7. Eligible Applicants

    Any public or private entity, including an Indian tribe or tribal 
organization (as defined at 25 U.S.C. 450b), is eligible to apply for 
grants or cooperative agreements for project categories covered in this 
announcement.

8. 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

[[Page 12083]]
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.
    The project abstract may be used in lieu of the one-page PHSIS, if 
the applicant is required to submit a PHSIS.

9. Executive Order 12372

    The MCH Federal set-aside 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: March 19, 1996.
Ciro V. Sumaya,
Administrator.
[FR Doc. 96-7106 Filed 3-22-96; 8:45 am]
BILLING CODE 4160-15-P