[Federal Register Volume 61, Number 160 (Friday, August 16, 1996)]
[Notices]
[Pages 42619-42628]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-20897]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Announcement No. 704]
Draft Program Announcement and Availability of Funds for Fiscal
Year 1997 Cooperative Agreements for Community-Based Human
Immunodeficiency Virus (HIV) Prevention Projects
Agency: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services.
Action: Request for comments.
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Summary: CDC is preparing to announce the availability of fiscal year
(FY) 1997 funds to support HIV prevention projects for minority and
other community-based organizations (CBOs). This program will assist
the Nation's disease prevention efforts by providing assistance to CBOs
in developing and implementing effective community-based HIV prevention
programs and promoting collaboration and coordination of HIV prevention
efforts among CBOs and local activities of HIV prevention service
agencies, public agencies including local and State health departments
(and HIV prevention community planning groups), substance abuse
agencies, educational agencies, criminal justice systems, and
affiliates of national and regional organizations. Because of the
unique nature of this program, CDC invites comments from organizations
and individuals on the draft of this announcement. Based on comments
received, the final announcement is expected to be published in
September 1996.
Dates: Written comments to this notice should be submitted to the
Office of the Director, National Center for HIV, STD, and TB
Prevention, Attention: Gary West, Centers for Disease Control and
Prevention (CDC), Mailstop D-21, Altanta, GA 30333. Comments must be
received on or before September 16, 1996.
For Further Information Contact: Gary West, Office of the Director,
National
[[Page 42620]]
Center for HIV, STD and TB Prevention, telephone (404) 639-0902.
Supplementary Information: The following is the complete text of the
draft program announcement for community-based human immunodeficiency
virus (HIV) prevention projects.
Introduction
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 1997 funds for cooperative agreements
for HIV prevention projects for minority and other community-based
organizations (CBOs) serving populations at increased risk of acquiring
or transmitting HIV infection.
(A cooperative agreement is a legal agreement between CDC and the
recipient in which CDC provides financial assistance and substantial
Federal programmatic involvement with the recipient during the
performance of the project.)
Preapplication technical assistance workshops to assist all
prospective applicants for these projects will be held during October
and November 1996. The purpose of these workshops is to assist
prospective applicants in understanding CDC application requirements
and program priorities. During the workshops, information will be
presented on application and business management requirements,
programmatic priorities, HIV prevention community planning, and how to
access additional preapplication resources relevant to application
development. Prospective applicants are encouraged to attend a workshop
in their area. For additional information on the preapplication
workshops in your area (a schedule will be included in the final
announcement), please contact your State or local health department or
CDC at telephone (404) 639-8317.
CDC is committed to achieving the health promotion and disease
prevention objectives of Healthy People 2000, a national activity to
reduce morbidity and mortality and improve the quality of life. This
announcement relates to the priority areas of Educational and
Community-Based Programs, HIV Infection, and Sexually Transmitted
Diseases (STDs). It addresses the ``Healthy People 2000'' objectives by
providing support for primary prevention for persons at increased risk
for HIV infection and by increasing the availability and coordination
of prevention and early intervention services for HIV-infected persons.
A summary of the HIV-related objectives will be included in the
application kit. (To order a copy of ``Healthy People 2000,'' see the
section entitled ``Where to Obtain Additional Information.'')
Authority
This program is authorized under section 317(k)(2) [42 U.S.C.
247b(k)(2)] of the Public Health Service Act, as amended.
Smoke-Free Workplace
CDC strongly encourages all grant recipients to provide a smoke-
free workplace and 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
To be eligible for funding under this announcement, applicants must
be a tax-exempt, non-profit CBO whose net earnings in no part accrue to
the benefit of any private shareholder or person. Tax-exempt status is
determined by the Internal Revenue Service (IRS) Code, Section
501(c)(3). Tax-exempt status may be proved by either providing a copy
of the pages from the IRS' most recent list of 501(c)(3) of tax-exempt
organizations or a copy of the current IRS Determination Letter. Proof
of tax-exempt status must be provided with the application.
Note: Organizations described in section 501(c)(4) of the
Internal Revenue Code of 1986 that engage in lobbying are not
eligible to receive Federal grant/cooperative agreement funds.
CBOs may apply as either (1) minority CBOs or (2) CBOs serving
other high-risk populations. To apply as a minority CBO the applicant
organization must have the following: (1) A governing board composed of
more than 50% racial or ethnic minority members, (2) a significant
number of minority individuals in key program positions, and (3) an
established record of service to a racial or ethnic minority community
or communities. In addition, if the applicant organization is a local
affiliate of a larger organization with a national board, the larger
organization must meet the same requirements listed above. If applying
as a minority CBO, proof of minority status must be provided with the
application. Affiliates of national organizations must provide proof of
their national organization's eligibility and include with the
application an original, signed letter from their chief executive
officer assuring their understanding of the intent of this program
announcement and the responsibilities of recipients.
Organizations applying as a CBO serving other high-risk populations
are not required to meet the minority requirements listed above.
CDC will not accept an application without proof of tax-exempt
status, minority status (if applicable), and proof of eligibility for
affiliates of national organizations (if applicable).
Applications requesting funds to support only administrative and
managerial functions will not be accepted.
Governmental or municipal agencies, their affiliate organizations
or agencies (e.g., health departments, school boards, public
hospitals), and private or public universities and colleges are not
eligible for funding under this announcement.
CBOs requesting funds under this announcement will be categorized
into one of two mutually exclusive groups: (1) High prevalence
Metropolitan Statistical Areas (MSAs); or (2) lower prevalence
geographic areas. For the purposes of this program, high prevalence
MSAs are defined by (1) greater than 500 reported AIDS cases in racial
or ethnic minorities (African Americans, Alaskan Natives, American
Indians, Asian Americans, Latinos/Hispanics, and Pacific Islanders) in
the 3-year period 1993, 1994, and 1995, or as Title I eligible
metropolitan areas (EMAs) for FY 1996 under the Ryan White
Comprehensive AIDS Resources Emergency (CARE) Act. (Title I EMAs are
defined as communities which as of March 31, 1995, reported a
cumulative total of more than 20,000 cases of AIDS within the EMA, or
that had a per capita incidence of cumulative cases of AIDS equal to or
exceeding 0.0025.) Eligible high prevalence MSAs (and the corresponding
OMB Federal Identification Processing (FIPS) code) are the following:
Arizona: Phoenix-Mesa (6200)
California: Los Angeles-Long Beach (4480), Oakland (5775), Orange
County (5945), Riverside-San Bernardino (6780), Sacramento (6920), San
Diego (7320), San Francisco (7360), San Jose (7400), Santa Rosa (7500)
Colorado: Denver (2080)
Connecticut: Hartford (3283), New Haven-Bridgeport-Stamford-Danbury-
Waterbury (5483)
Delaware-Maryland: Wilmington-Newark (9160)
District of Columbia-Maryland-Virginia-West Virginia: Washington, D.C.
(8840)
Florida: Ft. Lauderdale (2680), Jacksonville (3600), Miami (5000),
[[Page 42621]]
Orlando (5960), Tampa-St. Petersburg-Clearwater (8280), West Palm
Beach-Boca Raton (8960)
Georgia: Atlanta (520)
Illinois: Chicago (1600)
Louisiana: New Orleans (5560)
Maryland: Baltimore (720)
Massachusetts-New Hampshire: Boston-Worcester-Lawrence-Lowell-Brockton
(1123)
Michigan: Detroit (2160)
Minnesota-Wisconsin: Minneapolis-St. Paul (5120)
Missouri-Kansas: Kansas City (3760)
Missouri-Illinois: St. Louis (7040)
New Jersey: Newark (5640), Jersey City (3640), Bergan-Passaic (875),
Middlesex-Somerset-Hunterdon (5015), Monmouth-Ocean (5190), Vineland-
Millville-Bridgeton (8760)
New York: Duchess County (2281), New York City (5600), Nassau-Suffolk
(5380)
North Carolina-South Carolina: Charlotte-Gastonia-Rock Hill (1520)
Ohio: Cleveland-Lorain-Elyria (1680)
Oregon-Washington: Portland-Vancouver (6440)
Pennsylvania-New Jersey: Philadelphia (6160)
Puerto Rico: Caguas (1310), Ponce (6360), San Juan-Bayamon (7440)
South Carolina: Columbia (1760)
Tennessee-Arkansas-Mississippi: Memphis (4920)
Texas: Austin-San Marcos (640), Dallas (1920), Ft. Worth-Arlington
(2800), Houston (3360), San Antonio (7240)
Virginia-North Carolina: Norfolk-Virginia Beach-Newport News (5720),
Richmond-Petersburg (6760)
Washington: Seattle-Bellevue-Everett (7600)
CBOs not located in the aforementioned list of high prevalence MSAs
will be categorized as lower prevalence geographic areas.
Availability of Funds
In FY 1997, CDC expects a total of up to $17,000,000 to be
available for funding approximately 80 CBOs (70 in high prevalence MSAs
and 10 in lower prevalence geographic areas).
A. High Prevalence MSAs
Up to $16,000,000 of the total $17,000,000 will be made available
to CBOs in high prevalence MSAs. The estimated awards will average
$200,000 and will range from $75,000 to $300,000. In high prevalence
MSAs, $12,000,000 is dedicated to supporting minority CBOs that
represent and serve racial or ethnic minority persons and that meet the
criteria outlined in the section entitled Eligible Applicants. The
remaining $4,000,000 is dedicated to supporting CBOs serving other
high- risk populations in high prevalence MSAs.
B. Lower Prevalence Geographic Areas
The remaining $1,000,000 of the total funds expected will be made
available to fund CBOs in lower prevalence geographic areas. These
estimated awards will average $100,000. Of the $1,000,000 available, up
to $750,000 will support minority CBOs and at least $250,000 will
support CBOs serving other high-risk populations.
These estimates are subject to change based on the following: the
actual availability of funds; the scope and the quality of applications
received; appropriateness and reasonableness of the budget request;
proposed use of project funds; and the extent to which the applicant is
contributing its own resources to HIV/AIDS prevention activities.
However, no organization will be awarded more than $300,000 (direct and
indirect costs) per year. Applications for more than $300,000 will be
deemed ineligible and will not be accepted by CDC.
Funds available under this announcement must support activities
directly related to primary HIV prevention. However, intervention
activities which involve preventing other STDs and drug use as a means
of reducing or eliminating the risk of HIV infection may be supported.
No funds will be provided for direct patient medical care (including
substance abuse treatment, medical prophylaxis or drugs). These funds
may not be used to supplant or duplicate existing funding. Although
applicants may contract with other organizations under these
cooperative agreements, applicants must perform a substantial portion
of the activities (including program management and operations and
delivery of prevention services) for which funds are requested.
Awards will be made for a 12-month budget period within a 3-year
project period. (Budget period is the interval of time into which the
project period is divided for funding and reporting purposes. Project
period is the total time for which a project has been programmatically
approved.)
Noncompeting continuation awards for a new budget period within an
approved project period will be made on the basis of satisfactory
progress in meeting project objectives and the availability of funds.
Progress will be determined by site visits by CDC representatives,
progress reports, and the quality of future program plans. Proof of
eligibility will be required with the noncompeting continuation
application.
Background
The HIV epidemic constitutes a significant threat to the public
health of the United States. There are specific high-risk behaviors
that result in the transmission of HIV. HIV may also be transmitted
perinatally. Some of the important means currently available to reduce
the prevalence of behaviors placing individuals at risk of HIV
infection or transmission include:
A. Effective education and counseling to assist persons in
assessing their own high-risk behaviors and in planning behavior
change; to support and sustain behavior change; and to facilitate
linkages to other needed services;
B. Interpersonal skills training in negotiating and sustaining
appropriate behavior change; and
C. Influencing community norms in support of safer behaviors.
Purpose
This program will provide assistance to CBOs to: (1) Develop and
implement effective community-based HIV prevention programs (see the
section entitled Community Planning for HIV Prevention) consistent with
achieving national program goals, and the HIV prevention priorities
outlined in their State/local health department's comprehensive HIV
prevention plan (where available); and (2) promote collaboration and
coordination of HIV prevention efforts among CBOs and the local
activities of HIV prevention service agencies, public agencies
including local and State health departments (and HIV prevention
community planning groups), substance abuse agencies, educational
agencies, criminal justice systems, and affiliates of national and
regional organizations.
The national strategic goals for HIV, STD, and TB prevention are
to:
A. Increase public understanding of, involvement in, and support
for HIV, STD, and TB prevention.
B. Ensure completion of therapy for persons identified with active
TB or TB infection.
C. Prevent or reduce behaviors or practices that place persons at
risk for HIV and STD infection or, if already infected, place others at
risk.
D. Increase individual knowledge of HIV serostatus and improve
referral systems to appropriate prevention and treatment services.
E. Assist in building and maintaining the necessary State, local,
and community support infrastructure and technical capacity to carry
out prevention programs.
F. Strengthen current systems and develop new systems to accurately
[[Page 42622]]
monitor the HIV epidemic, STDs, and TB, as a basis for assessing and
directing prevention programs.
In order to maximize the effective use of CDC funds, each applicant
must conduct at least one, but no more than two, of the priority Health
Education/Risk Reduction (HE/RR) interventions described below.
Although activities may cross from one intervention type to another
(e.g., individual or group level interventions may be a part of a
community-level intervention), no more than two of the primary
interventions listed below should be undertaken.
HE/RR interventions include programs and services to reach persons
at increased risk of becoming HIV-infected or, if already infected, of
transmitting the virus to others. The goal of HE/RR interventions is to
reduce the risk of these events occurring. These interventions should
be directed to persons whose behaviors or personal circumstances place
them at high risk.
The following have been identified as successful HE/RR
interventions for HIV prevention and will be funded within the scope of
this announcement: Individual Level Interventions (including prevention
case management), Group Level Interventions, Community Level
Interventions, and Street and Community Outreach. The Guidelines for
Health Education and Risk Reduction Activities (included in the
application kit) will provide additional information on these
interventions. A brief description of the priority interventions
follows:
A. Individual Level Interventions provide a range of one-on-one
client services that offer counseling, assist clients in assessing
their own behavior and planning individual behavior change, support and
sustain behavior change, and facilitate linkages to services in clinic
and community settings (e.g., substance abuse treatment programs) in
support of behaviors and practices that prevent the transmission of
HIV. Some clients may be at very high risk of becoming HIV-infected or,
if already infected, of transmitting the virus to others. Additional
prevention counseling, as appropriate to the needs of these clients
should be offered.
Prevention Case Management is an individual level intervention
directed at persons who need highly individualized support, including
substantial psychosocial, interpersonal skills training, and other
support, to remain seronegative or to reduce the risk of HIV
transmission to others. HIV prevention case management services are not
intended as substitutes for medical case management or extended social
services. Services provided under this component should concentrate on
the identification, coordination, and receipt of appropriate prevention
services. Prevention case management services should complement ongoing
HIV prevention services such as HIV antibody counseling, testing,
referral, and partner notification (CTRPN), and early medical
intervention programs. Coordination with HIV counseling and testing
clinics, STD clinics, TB testing sites, substance abuse treatment
programs, and other health service agencies is essential to
successfully recruiting or referring persons at high risk who are
appropriate for this type of intervention.
B. Group Level Interventions shift the delivery of service from
individual to groups of varying sizes. Group level interventions
provide education and support in group settings to promote and
reinforce safer behaviors and to provide interpersonal skills training
in negotiating and sustaining appropriate behavior change to persons at
increased risk of becoming infected or, if already infected, of
transmitting the virus to others. The content of the group session
should be consistent with the format, i.e., groups can meet one time or
on an on-going basis. One-time sessions can provide participants an
opportunity to hear and learn from one another's experiences, role play
with peers, and offer and receive support. Ongoing sessions may offer
stronger social influence with potential for developing emergent norms
that can support risk reduction. A group level intervention can include
more tailored individual level interventions with some of the group
members.
C. Community Level Interventions are directed at changing community
norms, rather than the individual or a group, to increase community
support of the behaviors known to reduce the risk for HIV infection and
transmission. While individual and group level interventions also may
be taking place within the community, interventions that target the
community level are unique in their purpose and are likely to lead to
different strategies than other types of interventions. Community level
interventions aim to reduce risky behaviors by changing attitudes,
norms, and practices through health communications, social (prevention)
marketing, community mobilization and organization, and community-wide
events. The primary goals of these programs are to improve health
status, to promote healthy behaviors, and to change factors that affect
the health of community residents. The community may be defined in
terms of a neighborhood, region, or some other geographic area, but
only as a mechanism to capture the social networks that may be located
within those boundaries. These networks may be changing and
overlapping, but should represent some degree of shared communications,
activities, and interests. Community level interventions are designed
to impact on the social norms or shared beliefs and values held by
members of the community. Specific activities include:
Identifying and describing (through needs assessments and
ongoing feedback from the community) structural, environmental,
behavioral, and psychosocial facilitators and barriers to risk
reduction in order to develop plans to enhance facilitators and
minimize or eliminate barriers.
Developing and implementing, with participation from the
community, culturally competent, developmentally appropriate,
linguistically specific, and sexual-identity-sensitive interventions to
influence specific structural, environmental, behavioral, and
psychosocial factors thought to promote risk reduction.
Persuading community members who are at risk of acquiring
or transmitting HIV infection to accept and use HIV prevention
measures.
D. Street and Community Outreach Interventions are defined by their
locus of activity and by the content of their offerings. Street and
community outreach programs reach persons at high risk, individually or
in small groups, on the street or in community settings, and provide
them prevention messages, information materials, and other services,
and assist them in obtaining other primary and secondary HIV-prevention
services such as HIV-antibody counseling and testing, HIV risk-
reduction counseling, STD and TB treatment, substance abuse prevention
and treatment, family planning services, tuberculin testing, and HIV
medical intervention. Street and Community Outreach is an activity
conducted outside a more traditional, institutional health care setting
for the purpose of providing direct HE/RR services or referrals. The
fundamental principle of these outreach activities is that the outreach
worker/specialist establishes face-to-face contact with the client in
his/her own environment to provide HIV/AIDS risk reduction information,
services, and referrals.
Community Planning for HIV Prevention
In 1994, the 65 State and local health departments that received
CDC Federal funds for HIV prevention began an HIV
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prevention community planning process. The goal of HIV Prevention
Community Planning is to improve the effectiveness of HIV prevention
programs by strengthening the scientific basis and targeting prevention
interventions. Together, representatives of affected populations,
epidemiologists, behavioral scientists, HIV/AIDS prevention service
providers, health department staff, and others analyze the course of
the epidemic in their jurisdiction, determine their priority prevention
needs, and identify HIV prevention interventions to meet those needs.
Community planning groups are responsible for developing comprehensive
HIV prevention plans that are directly responsive to the epidemics in
their jurisdictions. Minority and other CBOs submitting applications
under this announcement must contact their State/local health
departments to obtain a copy of the current comprehensive HIV
prevention plan (if available). Program proposals must address high
priority needs identified in this plan. More information on the HIV
prevention community planning process is available from the HIV/AIDS
Program in your jurisdiction's health department. A list of the names
and telephone numbers of State health department points of contact to
obtain a copy of the jurisdiction's comprehensive HIV prevention plan
is provided with the application kit.
Program Requirements
In a cooperative agreement, there are roles and responsibilities
shared between the CDC (grantor) and the recipient of Federal funds
(awardee). In conducting activities to achieve the purpose of this
program, the recipient shall be responsible for the activities under A.
below; the CDC shall be responsible for activities under B. below; and
both the CDC and the recipient shall be responsible for the activities
under C. below:
A. Recipient Activities
The following four Health Education and Risk Reduction (HE/RR)
Interventions will be conducted. These include Individual Level
Interventions, Group Level Interventions, Community Level
Interventions, and Street and Community Outreach Interventions. Each
awardee must conduct at least one, but not more than two of the
priority HE/RR interventions. Recipient activities are listed below:
1. Coordinate and collaborate with other organizations and agencies
involved in HIV prevention activities, especially those serving the
target populations in the local area.
2. Coordinate with HIV counseling and testing clinics, STD clinics,
TB testing sites, substance abuse treatment programs, and other health
service agencies to recruit and refer persons of high risk who are
appropriate for individual level intervention.
3. Provide education and support in group settings to promote and
reinforce safer behaviors and to provide interpersonal skills training
in negotiating and sustaining appropriate behavior change to persons at
increased risk of becoming infected or, if already infected, of
transmitting the virus to others.
4. Identify the HIV/AIDS needs assessment of the community and
develop a linguistically specific and sexual-identity-sensitive
intervention plan to minimize barriers and to promote risk reduction.
5. Develop a street outreach program of face-to-face contact with
persons of high risk to provide HIV/AIDS risk reduction information,
services and referrals.
B. CDC Activities
1. Provide consultation and technical assistance in planning,
operating, and evaluating prevention activities.
2. Provide up-to-date scientific information on the risk factors
for HIV infection, prevention measures, and program strategies for
prevention of HIV infection.
3. Assist in the evaluation of program activities and services.
4. Assist recipients in collaborating with State and local health
departments and other HHS-supported HIV/AIDS recipients.
5. Facilitate the transfer of successful prevention interventions
and program models to other areas through convening meetings of
grantees, workshops, conferences, newsletters, and communications with
project officers.
6. Monitor the recipient's performance of program activities,
protection of client confidentiality, and compliance with other
requirements.
7. Facilitate exchange of program information and technical
assistance between community organizations, health departments, and
national and regional organizations.
8. Assist prospective applicants in obtaining preapplication
technical assistance and in obtaining copies of the comprehensive HIV
prevention plan.
C. Recipient and CDC Responsibility Regarding Confidentiality
All personally identifying information obtained in connection with
the delivery of services provided to any individual in any program
supported under this announcement shall not be disclosed unless
required by a law of a State or political subdivision or unless such an
individual provides written, voluntary informed consent.
1. Non-personally identifying, unlinked information, which
preserves the individual's anonymity, derived from any such program may
be disclosed without consent:
a. In summary, statistical, or other similar form, or
b. For clinical or research purposes.
2. Personally identifying information: Recipients of CDC funds that
must obtain and retain personally identifying information as part of
their CDC-approved work plan must:
a. Maintain the physical security of such records and information
at all times;
b. Have procedures in place and staff trained to prevent
unauthorized disclosure of client-identifying information;
c. Obtain informed client consent by explaining the possible risks
from disclosure and the recipient's policies and procedures for
preventing unauthorized disclosure;
d. Provide written assurance to this effect including copies of
relevant policies; and
e. Obtain assurances of confidentiality by agencies to which
referrals are made.
An Institutional Review Board (IRB) approval or a certificate of
confidentiality may be required for some projects.
Reporting Requirements
Quarterly narrative progress reports will be required 30 days after
the end of each quarter. Quarterly progress reports should document
services provided and problems encountered, with careful attention to
answering questions and documenting accomplishments and problems
encountered in meeting program objectives. Annual financial status
reports are required no later than 90 days after the end of each budget
period. Final financial status and performance reports are required 90
days after the end of the project period.
Application Requirements and Content
A. All applicants must develop their applications in accordance
with PHS Form 5161-1, and the general instructions, information, and
examples contained in the program announcement and section headings
listed below. In addition, applicants should request an application kit
(see section Where to Obtain Additional Information).
[[Page 42624]]
B. Applicants are required to show how the proposed priority HE/RR
intervention(s) and the target populations for which they are intended
to complement the HIV prevention priorities identified in the
jurisdiction's comprehensive HIV prevention plan. The applicant should
reference specific sections and pages in the comprehensive HIV
prevention plan that support their proposed plan. A list of the names
and telephone numbers of State health department points of contact from
whom applicants may obtain a copy of the jurisdiction's comprehensive
HIV prevention plan is provided with the application kit. If the
jurisdiction's comprehensive HIV prevention plan is not available or
does not adequately provide the necessary information, the applicant is
expected to justify the need and the priority of their proposed program
activities and summarize how the activities address prevention gaps and
complement ongoing prevention efforts. Technical assistance is
available to help with this.
C. The application for funding must include a detailed description
of the first year activities and a brief description of future year
activities.
D. In developing the application, CDC requires that applicants
follow the instructions and format outlined below:
1. a. Introduction (not to exceed 2 pages): Applicants should
briefly summarize the program for which funds are requested, including
the target population to be served, activities to be undertaken, and
services to be provided. Also, briefly describe proposed future year
activities.
b. Organizational History and Capacity: The applicant should
briefly describe as follows:
(1) A summary of programs provided in the past, both HIV prevention
and general service and education programs;
(2) Organizational structure, the interests and constituencies
represented, and examples of demonstrated or predicted ability to
implement outreach and education programs to reduce the spread of HIV;
(3) Commitment and ability (i) to work with a variety of
organizations and governmental programs including those providing HIV
prevention services, and (ii) to coordinate program development with
existing governmental and private educational efforts.
(4) Capacity to provide culturally competent and appropriate
education and outreach which responds effectively to the cultural,
environmental, social, and multilingual character of the target
populations, including documentation of any history of such outreach or
education.
2. Description of the Priority Target Population (not to exceed 2
pages): The applicant should clearly and specifically describe the
priority target population(s) to be served through the proposed
program, including the approximate number of individuals to be reached.
Using the comprehensive HIV prevention plan as the basis, the applicant
should describe the impact of the AIDS epidemic on the priority
population and their community and any specific environmental, social,
cultural, or multilingual characteristics of the priority populations
which the applicant has considered and addressed in developing
prevention strategies, such as:
a. HIV prevalence and reported AIDS cases in persons practicing
risky behaviors;
b. HIV/AIDS-related baseline knowledge, attitudes, beliefs, and
behavior;
c. Patterns of substance abuse and rates of STDs and tuberculosis
(TB); and
d. Other relevant information.
3. Description of the Needs Assessment (not to exceed 3 pages).
Using the State/local health department's comprehensive HIV prevention
plan as the basis, applicants should describe how their proposed HE/RR
interventions fill gaps or unmet needs identified in the area's
comprehensive HIV prevention plan. If requesting funds to support
continued implementation of an HE/RR intervention that is already in
place, the applicant should describe the gap or unmet need that would
result from discontinuation of services. In addition, the applicant
should describe ongoing HIV prevention and risk-reduction efforts
underway among the priority population(s), if any, and explain how
proposed interventions complement these ongoing services. Additionally,
the applicant should:
a. Explain any specific barriers to the dissemination of adequate
HIV-prevention information and education which exist or have existed;
and
b. Identify and describe the HIV prevention needs of the target
population(s) which the proposed program directly addresses.
If the jurisdiction's comprehensive HIV prevention plan is not
available or does not adequately provide the necessary information for
items B. and D.3. above, the applicant is expected to justify the need
and the priority of their proposed target population and program
activities, and summarize how the activities address prevention gaps
and complement ongoing prevention efforts. The available technical
assistance for these tasks is outlined in the section on Where to
Obtain Additional Information.
4. Program Plan (not to exceed 8 pages): The specific behaviors and
practices that the interventions are designed to promote should be
described, such as, increases in correct and consistent condom use,
knowledge of serological status, not sharing needles, and enrollment in
drug treatment and other preventive programs. The proposed plan should
also describe the opportunities available for representatives of the
target population to become active in planning, implementing, and
evaluating activities and services. In addition, the proposed plan
should describe how the proposed priority interventions and services
implemented to accomplish the proposed objectives are culturally
competent (i.e., program and services provided in a style and format
respectful of the cultural norms, values, and traditions that are
endorsed by community leaders and accepted by the target population),
sensitive to issues of sexual identity, developmentally appropriate
(i.e., information and services provided at a level of comprehension
that is consistent with learning skills of persons to be served),
linguistically-specific (i.e., information is presented in dialect and
terminology consistent with the target population's traditional
language and style of communication), and educationally appropriate.
The program plan should describe and explain:
a. Project objectives: What the project will accomplish (i.e.,
specific, time-phased, and measurable objectives for the project).
Approved programs must have objectives related to their jurisdiction's
comprehensive HIV prevention plan (if available) and national HIV
prevention goals, and should describe in realistic terms the expected
outcomes of program activities on its priority population(s).
b. Plan of Operation: How the project will work (i.e., what
specific activities will be conducted and services provided to
accomplish the objectives). The applicant should outline the major
steps or activities necessary to attain specified objectives, and note
the approximate dates by which activities will be accomplished. The
applicant should note all major activities which will represent
necessary milestones in the attainment of objectives. The plan should
describe, where possible, how the applicant will obtain participation
and input into the program by State or local health departments,
community planning groups, members of the target population, and other
appropriate service groups or organizations; and
[[Page 42625]]
how collaborative relationships with other agencies and organizations
will be established and maintained. Applicants must provide the
following as attachments: (a) A list of major community resources and
health care providers to which referrals will be made; (b) a plan for
ongoing training to ensure that staff are knowledgeable about HIV and
STD risks and prevention measures; (c) a plan to assess the performance
of staff to ensure that they are providing information and services
accurately and effectively; (d) a mechanism to initiate and verify
referrals; and (e) protocols to guide and document training,
activities, services, and referrals (e.g., applicants seeking funds for
Street and Community Outreach Interventions must provide a description
of the policies and procedures that will be followed to assure the
safety of outreach staff).
5. Plan of Evaluation (not to exceed 4 pages): How project
activities will be evaluated (i.e., a plan which will help determine if
the methods used to deliver these services are effective and the
objectives are being achieved). The applicant should clearly identify
specific methods it will use to measure progress toward attaining
objectives and monitoring activities during the first year of the
program. The applicant should describe how information will be
obtained, including a description of methods which will be implemented
to gather and record data, and in what manner it will be summarized.
The following are recommendations for the evaluation plan, the minimum
data that should be collected, and the systems for collecting the data.
Activities undertaken under the evaluation plan should be capable of
the following:
a. Providing a detailed description of:
(1) Each program activity and the documented need for that
activity; and
(2) Progress toward achieving each stated objective in the
cooperative agreement,
b. Providing detailed information for:
(1) The specific service or intervention that was provided and how
it differed from the planned services;
(2) The description and the number of persons who received the
service, including demographics such as age, race and ethnicity,
gender, and if appropriate and available, sexual orientation and risk
exposure, and how the persons actually served differed from those the
program intended to serve;
(3) When and how often the service or intervention was provided and
how this differed from program plans; and,
(4) Where the service or intervention was provided (e.g., CTRPN
site, STD clinic, street corner, housing project) and a comparison of
these data to the expected locations of service delivery.
c. Documenting and describing program successes, unmet needs,
barriers and problems encountered in planning, implementing, or
providing services, or in coordinating services with other
organizations and agencies serving target populations.
d. Documenting and describing the success of referral systems,
including the numbers of persons referred and the number actually
receiving services by site, and how well the system functions in
identifying sources of services and in assisting persons in obtaining
and receiving them.
e. Documenting and describing problems that affect planning or
implementing program activities (e.g., recruiting, hiring, or retaining
staff; training or ensuring quality staff performance; establishing or
maintaining contracts with other CBOs or ensuring the quality of their
performance), and
f. Describing client satisfaction with HIV prevention services.
Client satisfaction should be assessed periodically via quantitative or
qualitative methods (e.g., periodic focus groups with current or former
clients).
Because of the additional cost and need for scientific support
beyond the scope of these cooperative agreements, applicants should not
conduct outcome evaluations with these funds (i.e., long-term effects
of the program in terms of changes in behavior or health status, such
as changes in HIV incidence after the intervention). CDC will continue
to support special projects to evaluate the behavioral and other
outcomes of interventions commonly used by CBOs and other
organizations, and disseminate information and lessons learned from
this research to CBOs, health departments, community planning groups,
and other organizations and agencies involved in HIV prevention
programs.
6. Applicant Coordination of Efforts (not to exceed 4 pages):
In this section, applicants should document and describe how
proposed HE/RR priority intervention(s) and activities will be
coordinated with other organizations and agencies involved in HIV
prevention and education programs, especially those serving the target
population in the local area. Such organizations must include State and
local health departments and community planning groups, and should
include, as appropriate the following:
a. Community groups and organizations, including churches and
religious groups;
b. HIV/AIDS service organizations;
c. Ryan White CARE planning bodies;
d. Schools, boards of education, and other State or local education
agencies;
e. State and local substance abuse agencies and drug treatment or
detoxification programs;
f. Federally funded community projects, such as those funded by
Center for Substance Abuse Treatment (CSAT), Center for Substance Abuse
Prevention (CSAP), Health Resource Services Administration (HRSA),
Office of Minority Health (OMH), and other Federal agencies;
g. Providers of services to youth in high risk situations (e.g.,
youth in shelters);
h. State or local departments of mental health;
i. Juvenile and adult criminal justice, correctional or parole
systems and programs;
j. Family planning and women's health agencies; and
k. STD and TB clinics and programs.
Applicants should submit and include as attachments memoranda of
understanding or agreement as evidence of these established or agreed-
upon collaborative relationships. Evidence of continuing collaboration
must be submitted each year to ensure that the collaborative
relationships are still in place.
7. Personnel: The applicant should describe in detail each existing
or proposed position for this program by job title, function, general
duties, and activities. This should include the level of effort and
allocation of time for each project activity by staff positions. If the
identity of any key personnel who will fill a position is known, her/
his name and curriculum vitae (not to exceed one page each) should be
attached. Experience and training related to the proposed project
should be noted.
8. Budget Breakdown and Justification: The applicant should provide
a detailed budget for each HE/RR intervention (i.e., individual level,
group level, community level, or street and community outreach) to be
undertaken, with accompanying justification of all operating expenses
that is consistent with the stated objectives and planned priority
activities. CDC may not approve or fund all proposed activities.
Applicants should be precise about the program purpose of each budget
item, and should itemize calculations wherever appropriate.
For the personnel section, the job title, annual salary/rate of
pay, and
[[Page 42626]]
percentage of time spent on this program should be indicated.
For contracts contained within the application budget, applicants
should name the contractor, if known; describe the services to be
performed; justify the use of a third party; and provide a breakdown of
and justification for the estimated costs of the contracts; the kinds
of organizations or parties to be selected; the period of performance;
and the method of selection.
Attachments
The applicant must also provide the following as attachments:
A. Proof of its nonprofit status, as set forth under the Eligible
Applicants section. No awards will be made without acceptable proof of
nonprofit status;
B. A list of the members of its governing body and, for minority
CBO applicants, their racial/ethnic backgrounds;
C. An organizational chart of existing and proposed staff,
including volunteer staff (minority CBOs should include racial/ethnic
backgrounds);
D. A description of any funding being received from CDC or other
sources to conduct similar activities which includes:
1. A summary of funds and income received to conduct HIV/AIDS
programs and other programs targeting the population proposed in the
program plan. This summary must include the name of the sponsoring
organization/source of income, level of funding, a description of how
the funds have been used, and the budget period. In addition, identify
proposed personnel devoted to this project who are supported by other
funding sources and the activities they are supporting;
2. A summary of the objectives and activities of the funded
program(s);
3. A description of how funds requested in this application will be
used differently or in ways that will expand upon the funds already
received, applied for, or being received; and
4. An assurance that the funds being requested will not duplicate
or supplant funds received from any other Federal or non-Federal
source.
E. Evidence of collaboration between the health department and
other organizations serving the target population.
F. Independent audit statements from a certified public accountant
for the previous 2 years.
G. Other information that may be required of organizations seeking
support for priority HE/RR intervention(s).
H. Typing and Mailing
Applicants are required to submit an original and 2 copies of the
application. Pages must be clearly numbered, and a complete index to
the application and its appendices must be included. Please begin each
separate section of the application on a new page. The original and
each copy of the application set must be submitted unstapled and
unbound. All material must be typewritten, single spaced, with
unreduced type on 8\1/2\'' by 11'' paper, with at least 1'' margins,
headings and footers, and printed on one side only. Materials which
should be part of the basic plan will not be accepted if placed in the
appendices.
Review and Evaluation Criteria
Eligible applications will be evaluated by a two-step process. Step
1 is a review of the merits of the application against the criteria
listed in A.1. below. If an exceptionally large number of applications
are received, CDC may conduct a two-phased review in which all
applications receive a preliminary review ((A.1.-A.3. below) and the
applications with high ratings receive the second phase of the review
(A.1.-A.7.). Step 2 is a predecisional site visit.
CDC-convened Special Emphasis Panels will evaluate each application
by the following criteria:
A. Application
Each application will be evaluated based on the following criteria:
1. Extent of experience in providing HIV prevention services to the
target population; (15 points)
2. Extent of need for the program as evidenced by the comprehensive
HIV prevention plan and other needs assessment information provided by
the applicant; (15 points)
3. Extent that the applicant in the program plan identifies and
describes how proposed HE/RR interventions address prevention gaps
related to their proposed priority population(s); (10 points)
4. Degree to which the proposed objectives are specific,
measurable, time-phased, related to the proposed activities, related to
prevention priorities outlined in the jurisdiction's comprehensive HIV
prevention plan and national HIV prevention goals, and consistent with
the applicant organization's overall mission; (20 points)
5. The quality of the applicant's plan for conducting program
activities, and the potential effectiveness of the proposed activities
in meeting objectives; (20 points)
6. Degree of collaboration and coordination with other
organizations serving the same priority population(s). This includes
signed work plans, agreements, or other evidence of collaboration that
describe previous, current, as well as future areas of collaboration;
and (10 points)
7. The potential of the evaluation plan to measure the
accomplishment of program objectives. (10 points)
B. Predecisional Site Visits
Before final award decisions are made, CDC may make site visits to
CBOs whose applications are highly ranked. The purpose of these site
visits will be to assess the organizational and financial capability of
the applicant to implement the proposed program.
A fiscal Recipient Capability Audit may be required of some
applicants prior to the award of funds.
Funding Priorities
In making awards, priority will be given to (1) Ensuring a
geographic balance of funded CBOs (the number of funded CBOs may be
limited in each eligible area based on the number of reported AIDS
cases, e.g., no more than one funded CBO for each 1,000 reported AIDS
cases in minority populations in 1993, 1994, and 1995), (2) providing
support to racial and ethnic minority CBOs and CBOs serving other high
risk populations with proven records of effectively reaching their
target populations, and (3) supporting activities that address the HIV
prevention priorities identified in the health department's
comprehensive HIV prevention plan (if available).
Executive Order 12372 Review
Applications are subject to review as governed by Executive Order
(E.O.) 12372, Intergovernmental Review of Federal Programs. E.O. 12372
sets up a system for State and local government review of proposed
Federal assistance applications. Applicants should contact their State
single point of contact (SPOC) as early as possible to alert them to
the prospective applications and receive instructions on the State
process. For proposed projects serving more than one State, the
applicant is advised to contact the SPOC for each State. A current list
of SPOCs is included in the application kit. If SPOCs have any State
process recommendations on applications submitted to CDC, they should
forward them to Van Malone, Grants Management Officer, Grants
Management Branch, Procurement and Grants Office, Centers for Disease
Control and Prevention (CDC), 255 East
[[Page 42627]]
Paces Ferry Road, NE., Room 300, Mail Stop E-15, Atlanta, GA 30305, no
later than 60 days after the application deadline date CDC does not
guarantee to accommodate or explain State process recommendations it
receives after that date.
Public Health System Reporting Requirements
This program is subject to the Public Health System Reporting
Requirements. Under these requirements, all community-based
nongovernmental applicants must prepare and submit the items identified
below to the head of the appropriate State and/or local health
agency(s) in the program area(s) that may be impacted by the proposed
project no later than the receipt date of the Federal application. The
appropriate State and/or local health agency is determined by the
applicant. The following information must be provided:
A. A copy of the face page of the application (SF 424);
B. A summary of the project that should be titled ``Public Health
System Impact Statement (PHSIS)'', not to exceed one page, and include
the following:
1. A description of the population to be served;
2. A summary of the services to be provided; and
3. A description of the coordination plans with the appropriate
State and/or local health agencies.
Catalog of Federal Domestic Assistance Number
The Catalog of Federal Domestic Assistance Number is 93.939, HIV
Prevention Activities--Non-Governmental Organization Based.
Other Requirements
A. HIV Program Review Panel
Recipients must comply with the terms and conditions included in
the document titled Content of HIV/AIDS-Related Written Materials,
Pictorials, Audiovisuals, Questionnaires, Survey Instruments, and
Educational Sessions in Centers for Disease Control and Prevention
(CDC) Assistance Programs (June 1992), a copy of which is included in
the application kit. In complying with the program review panel
requirements contained in this document, recipients are encouraged to
use a current program review panel such as the one created by the State
health department's HIV/AIDS Prevention Program. If the recipient forms
its own program review panel, at least one member must also be an
employee or a designated representative of a State or local health
department. The names of review panel members must be listed on the
Assurance of Compliance Form, CDC 0.1113.
B. Accounting System
The services of a certified public accountant licensed by the State
Board of Accountancy or equivalent must be retained throughout the
budget period as a part of the recipient's staff or as a consultant to
the recipient's accounting personnel. These services may include the
design, implementation, and maintenance of an accounting system that
will record receipts and expenditures of Federal funds in accordance
with accounting principles, Federal regulations, and terms of the
cooperative agreement.
C. Audits
Funds claimed for reimbursement under this cooperative agreement
must be audited annually by an independent certified public accountant
(separate and independent of the consultant referenced above or
recipient's staff certified public accountant). This audit must be
performed within 60 days after the end of the budget period, or at the
close of an organization's fiscal year. The audit must be performed in
accordance with generally accepted auditing standards (established by
the American Institute of Certified Public Accountants (AICPA)),
governmental auditing standards (established by the General Accounting
Office (GAO)), and Office of Management and Budget (OMB) Circular A-
133.
D. Human Subjects
If the proposed project involves research on human subjects, the
applicant must comply with the Department of Health and Human Services
Regulations (45 CFR Part 46) regarding the protection of human
subjects. Assurance must be provided (in accordance with the
appropriate guidelines and form provided in the application kit) to
demonstrate that the project will be subject to initial and continuing
review by an appropriate institutional review committee.
E. Paperwork Reduction Act
OMB clearance for the data collection initiated under this
cooperative agreement is pending approval by the Office of Management
and Budget.
Application Submission and Deadline
The original and two copies of the application (PHS Form 5161-1,
OMB Number 0937-0189) must be submitted to Mr. Van Malone, Grants
Management Officer, Grants Management Branch, Procurement and Grants
Office, Centers for Disease Control and Prevention (CDC), 255 East
Paces Ferry Road, NE., Room 300, Mail Stop E-15, Atlanta, GA 30305, on
or before October 15, 1996. Faxed copies will NOT be accepted. In
addition, CDC strongly recommends that all applicants, simultaneously
submit a copy of the application to their State HIV/AIDS Directors.
Deadline: Applications will meet the deadline if they are either
received on or before the deadline date, or sent on or before the
deadline date and received in time for submission to the review group.
(Applicants must request a legibly dated U.S. Postal Service postmark
or obtain a legibly dated receipt from a commercial carrier or U.S.
Postal Service. Private metered postmarks will not be acceptable proof
of timely mailing.)
Applications that do not meet these criteria will be considered
late and will not be considered in the current funding cycle. Late
applications will be returned to the applicant.
Where to Obtain Additional Information
To receive the application kit, call (404) 332-4561. You will be
asked to leave your name, address, and telephone number; and you must
refer to Announcement Number 704. You will then receive program
announcement 704, required application forms and attachments, a current
list of SPOCs, a summary of HIV related objectives, a list of the State
health department points of contact, and the HE/RR guidelines. The
announcement is also available through the CDC home page on the
Internet. The address for the CDC home page is http://www.cdc.gov.
If you have questions after reviewing the contents of the
documents, business management technical assistance may be obtained
from Maggie Slay, Grants Management Specialist, Grants Management
Branch, Procurement and Grants Office, Centers for Disease Control and
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 300, Mail Stop
E-15, Atlanta, GA 30305, telephone (404) 842-6797, or INTERNET address,
[email protected].
Announcement Number 704, ``Cooperative Agreements for Minority
Community-Based Human Immunodeficiency Virus (HIV) Prevention
Projects'' must be referenced in all requests for information
pertaining to these projects.
Programmatic technical assistance may be obtained by calling Norm
Fikes
[[Page 42628]]
in the Division of HIV/AIDS Prevention, National Center for HIV, STD,
and TB Prevention, Centers for Disease Control and Prevention (CDC),
Mail Stop E-58, Atlanta, GA 30333, telephone (404) 639-8317. (Technical
assistance may also be obtained from your respective State/local health
departments.)
Preapplication Workshops will be held in October and November 1996.
Prospective applicants are encouraged to attend a workshop in their
area. The purpose of these workshops is to assist prospective
applicants in understanding CDC application requirements and program
priorities. During the workshops, information will be presented on this
application guidance, programmatic priorities, HIV prevention community
planning, CDC business management requirements, and how to access
additional preapplication resources relevant to application
development. For additional information concerning workshops in your
area, please contact your State or local health department or a project
officer in the Division of HIV/AIDS Prevention, National Center for
HIV, STD, and TB Prevention, Centers for Disease Control and Prevention
(CDC), Mail Stop E-58, Atlanta, GA 30333, telephone (404) 639-8317.
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) 512-1800.
Dated: August 12, 1996.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for
Disease Control and Prevention.
[FR Doc. 96-20897 Filed 8-15-96; 8:45 am]
BILLING CODE 4163-18-P