[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