[Federal Register Volume 61, Number 242 (Monday, December 16, 1996)]
[Notices]
[Pages 66047-66052]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-31822]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Announcement Number 711]


Cooperative Agreement Program To Strengthen the Public Health 
System by Effectively Translating the Essential Public Health Services 
Into Practice

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1997 funds for a cooperative agreement 
program with national public health associations and organizations to 
strengthen the public health system by effectively translating the 
essential public health services into practice. The 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 is related 
to Objective 8.14 of Healthy People 2000: National Health Promotion and 
Disease Prevention Objectives: ``Increase to at least 90 percent the 
proportion of people who are served by a local health department that 
is effectively carrying out the core functions of public health.'' (To 
order a copy of ``Healthy People 2000,'' see the section WHERE TO 
OBTAIN ADDITIONAL INFORMATION.
    The Institute of Medicine (IOM) defined the mission of public 
health as fulfilling society's interest in assuring conditions in which 
people can be healthy (The Future of Public Health, IOM, 1988). CDC 
proposes to support associations and organizations with a clearly 
defined membership or constituency and the capacity to serve 
communities across the nation. This ensures that all communities--
urban, suburban, and rural--have the opportunity to access and receive 
the benefits of this comprehensive implementation strategy.
    The CDC has committed substantial resources to promote and 
ultimately measure the implementation and impact of the Essential 
Public Health Services (see Attachment 1 which is included in the 
application kit). This program will also contribute to an overall 
strategy to assure the achievement of the Year 2000: National Health 
Promotion and Disease Prevention Objectives. To

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ensure that the perspectives of the communities and local values are 
appropriately integrated into local public health policy and program 
implementation plans, public health associations and the professionals 
they represent must be engaged collectively and collaboratively.

    Authority: This program is authorized under section 317(k)(2) of 
the Public Health Service Act, 42 U.S.C. 247b(k)(2), as amended.

Smoke-Free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the nonuse of all tobacco products, and 
Public Law 103-277, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities that receive Federal funds in which education, 
library, day care, health care, and early childhood development 
services are provided to children.

Eligible Applicants

    Eligible applicants are national, nonprofit, nonacademic 
associations and organizations, whose primary mission is to represent 
State and local public health practitioners and policy makers.
    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.

Availability of Funds

    Approximately $800,000 is expected to be available in FY 1997 to 
fund 3-5 cooperative agreements. It is expected that the average award 
will be $200,000 per year, ranging from $100,000 to $300,000 per year 
(includes both direct and indirect costs). Applications requesting 
$350,000 or more, will not be considered and will be returned to 
applicants. It is expected that the awards will begin on or about May 
1, 1997, and will be made for a 12-month budget period within a project 
period of up to 3 years. The funding estimate may vary and is subject 
to change. Continuation awards within the project period will be made 
on the basis of satisfactory progress and the availability of funds.
    Cooperative agreement funds may not supplant or duplicate existing 
funding from any other public or private source. Although contracts 
with other organizations are allowable, grantees must perform a 
substantial portion of each activity for which funds are requested. 
Funds may not be expended for construction, renovation of existing 
facilities, or relocation of headquarters, affiliates, or personnel.

Background

    The Essential Public Health Services (Essential Services) provide a 
contemporary definition of the practice of public health. The Essential 
Services were developed in collaboration with representatives from 
major public health professional associations and organizations and 
supported by CDC. While acknowledged and endorsed by public health 
professionals, the Essential Services have not been fully integrated 
into public health agencies. They remain mostly conceptual, in part due 
to an absence of a nationally-focused, comprehensive implementation 
strategy. This program and the resulting cooperative agreements will 
facilitate development and implementation of a comprehensive, national 
strategy to integrate the services into the practice of public health. 
Please see Attachment 1(included in the application kit) for more 
information regarding the Essential Public Health Services.
The Essential Public Health Services are:
    (1) Monitor health status to identify community health problems.
    (2) Diagnose and investigate health problems and health hazards in 
the community.
    (3) Inform, educate, and empower people about health issues.
    (4) Mobilize community partnerships to identify and solve health 
problems.
    (5) Develop policies and plans that support individual and 
community health efforts.
    (6) Enforce laws and regulations that protect health and ensure 
safety.
    (7) Link people to needed personal health services and assure the 
provisions of health care when otherwise unavailable.
    (8) Assure a competent public health and personal health care 
workforce.
    (9) Evaluate effectiveness, accessibility, and quality of personal 
and population-based health services.
    (10) Research for new insights and innovative solutions to health 
problems.
    Activities should be designed to increase understanding, adoption, 
and ultimately full implementation of the Essential Services into the 
practice of public health. Implementation refers to official public 
health agencies incorporating the language into operational planning 
and the policies and procedures of their programs and services.
    CDC's partnership activities have sought to strengthen the public 
health system within all communities through collaboration with local, 
State, and national partners. This program will further strengthen 
these partnerships and extend the reach of CDC's community-based 
activities.
    In September 1995, the CDC Director presented his vision of 
partnership at the annual meeting of State and Territorial Health 
Officials. This vision outlined three critical ``principles of 
partnership.'' This program announcement addresses each of these 
principles. The first principle--shared vision--will be achieved by 
asking each applicant to, individually and collectively, focus their 
creative efforts on the development and implementation of a 
comprehensive, national strategy to integrate the Essential Services 
into the practice of public health. The second principle--regular, 
effective communication--will be achieved, as each applicant will 
develop an internal capacity building plan. This internal plan will 
focus on identified needs, with particular emphasis on enhancing 
internal skills that will improve electronic communication and 
information-sharing. The final principle of partnership--building 
capacity in the community--will be achieved by encouraging associations 
to undertake projects and activities that will strengthen their 
internal ability to improve community capacities.
    Applicants are encouraged to design and develop creative and 
innovative methodologies and solutions, and seize every opportunity to 
accelerate the transfer of the Essential Services into all State and 
local health agencies and thousands of communities. In addition, this 
program will enhance the existing collaborative partnerships 
established between CDC and national public health associations and 
organizations.

Purpose

    The purpose of this program is for CDC to develop and sustain 
partnerships between national associations and organizations in order 
to strengthen the public health system by effectively incorporating the 
Essential Services into the practice of public health. This cooperative 
agreement program will:
    A. Introduce a more contemporary model for supporting public health 
partnerships and providing associations with increasing flexibility for 
administrative decision-making.
    B. Ensure the health of the public is best protected and served by 
integrating the efforts of grantees and their constituency to 
coordinate activities toward incorporation of these services into the 
practice of public health.

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    C. Ensure that national public health associations and 
organizations are supported to provide the most effective and 
sustainable leadership and consensus of mission.
    D. Enhance existing partnership linkages between State and local 
health agencies, private providers, foundations, and other 
organizations in support of the Essential Services.
    E. Improve understanding and integration of all levels of 
governance through coordination of public health policy and program 
implementation.
    F. Improve overall public health management by undertaking 
activities that value and respect diversity among the professional 
disciplines represented in public health.
    G. Increase partnership opportunities with private sector 
providers, nonprofit and not-for-profit organizations and Federal 
agencies with responsibilities for the health of the public.
    Priority consideration will be given only to applications 
supporting CDC's initiative to strengthen the public health system with 
a distinctive focus on the Essential Public Health Services. While 
there is not an exact formula for distribution of funds across the 
identified priorities (see the section ``Recipient Activities''), CDC/
Public Health Practice Program Office (PHPPO) offers the following 
guidance: (a) At least 30% of the requested funds will be dedicated to 
Priority #1, (b) at least 20% of the requested funds will be dedicated 
to Priority #2, and (c) at least 10% of the requested funds will be 
dedicated to Priority #3. This ``level of emphasis'' recognizes the 
differing needs and capacities among potential applicants. Therefore, 
CDC/PHPPO expects applicants to present varied plans which justify 
distribution of funds, and are appropriate for the respective 
association or organization. This guidance further reinforces CDC's 
commitment to strengthening partnerships by requiring each applicant to 
identify the most appropriate association-specific distribution of the 
balance of the funding request.

Program Requirements

    To be considered for funding under this program announcement, 
applicants must address each of the three priorities listed below. 
Successful partnership strategies must focus on identified priorities. 
The priorities identified in this program announcement provide a 
framework for potential applicants to develop and focus their proposal. 
This framework offers an opportunity for organizations to focus more 
emphasis on performance measures and specific indicators. CDC fully 
recognizes and accepts the probability that applicants will submit 
applications with varying degrees of emphasis for each identified 
priority.
    Activities proposed must be consistent with the intent of the 
priority area. Each activity should be constructed in the context of 
how it will contribute to the priority and ultimately, to a national 
strategy for implementation of the Essential Services. Creative, 
innovative activities are encouraged, but applicants are cautioned that 
implementation plans must be designed to achieve stated objectives. All 
activities should be coordinated with CDC, and when practical, in 
collaboration with relevant national, regional, State, and local public 
health groups.
    An expectation of this program is that each grantee becomes an 
advocate for the Essential Services as ``the standard'' for official 
health agencies and supports agency efforts to incorporate the 
Essential Services language into their official statements of 
authority, mission, and operational planning.
    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the following activities under A. 
(Recipient Activities), and CDC will be responsible for conducting 
activities under B. (CDC Activities).
A. Recipient Activities
    Priority #1  Promote as a long-term public health system's outcome, 
the translation of the Essential Services as ``the standard'' for the 
practice of public health.
    Projects/activities that may accelerate the translation of 
Essential Services into public health practice may include: (1) 
Promoting partnerships, such as joint projects, meetings, workshops, 
and conferences, (2) demonstrating association support for the 
Essential Services through position papers, resolutions, and formal 
recommendations, (3) enhancing the Essential Services or a defined 
subset, (4) promoting dialogue that will result in consensus 
definitions for the Essential Services, and (5) supporting 
``Implementation of Essential Public Health Services'' as a Year 2010, 
national health objective.
    Priority #2  Improve project planning and implementation of the 
grantee and their constituencies, whereby evaluation plans focus on 
objectives and indicators of measurable performance.
    Projects/activities that may emphasize performance may include: (1) 
Increasing the grantee's management staff capacities to conduct 
performance-based planning, implementation, and evaluation, (2) 
developing appropriate indicators for measuring effectiveness of 
activities, including projects that focus on training, consultation, 
and technical assistance, (3) initiating a process for peer review of 
projects/activities, (4) developing procedures for sharing resources 
among partners, and (5) increasing capacity to access and utilize 
relevant electronic communication networks.
    Priority #3  Build the internal capacities of the grantee to 
develop, enhance, and sustain partnership activities among both 
traditional and non-traditional groups.
    Projects/activities that may enhance the internal capacities of the 
association/organization may include: (1) Conducting an internal needs 
assessment (e.g., Assessment Protocol for Excellence in Public Health--
APEXPH, Part I) (2) developing a plan to address identified needs, (3) 
identifying opportunities to secure new revenue sources, (4) developing 
procedures to secure individuals with critical skills for special 
short-term needs, (e.g., survey design), (5) acquiring hard- and 
software to increase electronic communication and information-sharing 
capacity, and (6) developing an organizational capacity to augment 
project implementation with technical assistance.
B. CDC Activities
    1. Provide information to, and collaborate with, funded 
associations and organizations in developing and implementing short- 
and long-term plans.
    2. Provide consultation, assistance, and guidance in planning and 
implementing program activities under this announcement including 
promotion and publicity related to accomplishments.
    3. Assist in identifying, acquiring, or developing appropriate 
materials to be used in projects and activities.
    4. To the extent that resources and skilled personnel are 
available, provide science-based collaboration and technical 
assistance.
    5. Provide technical assistance in developing and implementing 
evaluation strategies for the program.
    6. Facilitate collaboration with other public and private sector 
agencies involved at the national, regional, State, and community 
levels and facilitate technical assistance between other public and 
private agencies at all levels.
    7. Facilitate the exchange of program information and technical 
assistance among public and private agencies at all levels.

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    8. Monitor the successful applicants' performance, projects, 
activities for compliance with all programmatic, administrative, and 
budgetary requirements.

Technical Reporting Requirements

    All reports must be submitted to Ron Van Duyne, Grants Management 
Officer, Attention: David Elswick, Grants Management Branch, 
Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 321, Mailstop E-
13, Atlanta, GA 30305. The following reports are required:
    A. An original and two copies of a quarterly narrative progress 
report (not to exceed 4 pages) for the first, second and fourth 
quarters of each budget period due to CDC no later than 30 days after 
the end of each quarter.
    B. A cumulative progress report for the first three quarters of 
each budget period as part of a grantee's continuation application for 
funding during the project period (this report will serve as the third 
quarter report). Progress reports should document activity status in 
comparison to the stated objectives and other relevant observations. 
Awardees should pay careful attention to answering the evaluation 
questions and documenting accomplishments and problems encountered in 
meeting program objectives, as described in the evaluation requirements 
section in their reports. The progress report is intended not only as a 
way of informing CDC of the progress made by cooperative agreement 
recipients in implementing projects and activities and evaluating 
performance, but also as a tool for documenting and sharing important 
information with other organizations and agencies. CDC may share 
portions of the progress report with other partners, grantees and 
Centers/Institute/Offices within CDC.
    C. A Financial Status Report (FSR) no later than 90 days after the 
end of each budget period. A final FSR and performance report are 
required no later than 90 days after the end of the project period.

Application Content

     Applications must be prepared in accordance with PHS Form 5161-1, 
information contained in the program announcement, and the general 
instructions outlined below. When writing the application, careful 
consideration should be given to the ``Evaluation Criteria'' section 
below. The applicant should provide a detailed description of the 
objectives, program plan, intended collaboration(s), and evaluation 
activities for the first-year budget period only and briefly describe 
future activities during the project period. If indirect costs are 
requested, a current, approved indirect cost rate agreement must be 
included with the application.
    Proof of nonprofit and organizational status and compliance with 
all other eligibility criteria must be submitted with the application 
for determination of eligibility.
    Applicants must use the following format for the narrative portion 
of their applications and refer to the relevant program requirements 
and guidance, address requirements and issues in A-G as follows, and 
consider the review and evaluation criteria when developing the 
application. Applicants must address all three priorities, but have 
some discretion regarding the level of activity and commitment of 
funds.
    A. Abstract (not to exceed 1 page): Summarize the overall proposal 
including the applicant's organizational structure, projects/
activities, funding request, collaboration and coordination with CDC 
and other national associations and organizations, and relationship to 
priority area.
    I. Translating the Essential Services into public health practice 
(Priority #1)
    II. Increasing emphasis on performance measures (Priority #2)
    III. Enhancing internal capacities (Priority #3)
    B. Program Rationale and Need (not to exceed three pages):
    1. For activities related to the Essential Services, describe the 
rationale for the projects/activities and include a summary of existing 
information on identified association needs that the proposed program 
will help address. This should include a description of the activity, 
the expected impact on the need, and an explanation of how the activity 
will contribute to the national strategy to strengthen the public 
health system, particularly as it relates to the Essential Public 
Health Services.
    2. For activities that focus on increasing performance, applicants 
should focus their attention to progress relative to their objectives. 
In situations where the performance is difficult to measure or not 
easily quantifiable, the proposal should outline activities with a 
series of time-phased tasks to be completed during the budget period.
    3. For capacity building activities, including staff training, 
describe the need(s) to be met, why it is necessary, and how it will 
impact or benefit the association. This should include an explanation 
of how this capacity building activity may contribute to the overall 
national implementation strategy. Any relevant evidence supporting this 
need should be included in the application.
    C. Program Objectives (not to exceed one page): Specify the 
measurable program objectives. An outcome objective will address (at 
least partially) resolution of an unmet need. Include at least one 
outcome objective for each priority, and the indicators that will be 
used to measure activities and benchmarks toward meeting those 
objectives.
    D. Detail Experience (not to exceed two pages): Specify time, 
project title, and organization's role related to previous public 
health initiatives. Accomplishments with supporting documentation and 
evidence of an association's sustainability will be a critical 
component in the evaluation phase of each applicant's proposal. An 
applicant's experience should be described in relation to its ability 
to provide technical assistance and/or training or other relevant 
technical assistance to affiliates, constituency groups, other 
organizations, and agencies. This should also demonstrate the 
applicant's understanding of the varying information needs of those 
working with specific audience segments, and how these varying needs 
will be addressed.
    E. Collaboration/Coordination (not to exceed two pages):
    1. Describe in sufficient detail the intended collaboration, 
coordination, and relationships with CDC; regional, State, and local 
affiliates, members, etc.; other national organizations; State/local 
health agencies; community-based organizations; and other organizations 
and agencies. Letters of support would be evidence of collaboration.
    2. Describe the role of each of the collaborating organizations, 
including the specific activities each will undertake in the proposed 
program plan. Describe proposed technical assistance activities 
anticipated and summarize other efforts to secure collaboration in the 
proposed program plan.
    3. Describe past experience, if any, in collaborating and 
coordinating programs and activities among other organizations.
    4. Include in the attachments evidence of past collaboration and 
coordination, such as jointly-developed work plans or memoranda of 
understanding.
    F. Evaluation Plan (not to exceed two pages): Describe the plan for 
evaluating program activities and services. Indicate how progress 
toward achieving objectives will be measured and how the quality of 
services will be ensured

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or how the applicant will work with CDC to develop and implement a 
comprehensive evaluation plan. Describe how needs for technical 
assistance and training will be identified and monitored, and specify 
the process through which program objectives and plans will be modified 
to meet the emerging and changing needs of target populations and the 
organizations and agencies serving them.
    G. Attachments (attach the following documents):
    1. Proof of the applicant organization's nonprofit status.
    2. A list of participating affiliates or organizations, or 
description of the constituency(ies) served by the applicant.
    3. A list of the names, addresses, and phone numbers of members of 
the board(s) or governing body(ies) for the applicant.

Evaluation Criteria

    Applications will be objectively reviewed and evaluated in 
accordance with the following criteria:
I. Review and Evaluation of Application
A. Organizational Capability (20%) 

    The extent to which the applicant documents:
    (1) Recent experience administering/ coordinating health-related, 
public health, or community-based programs in conjunction with a 
national plan, and
    (2) Ability to access and influence a particular sector such as 
public, private, professional, voluntary groups through a network of 
affiliates, constituents, or members, and
    (3) Capacity (or planned capacity) to provide technical assistance 
and training to their affiliates, constituents, members, and others 
regarding the Essential Services.

B. Understanding of the Problem (15%)

    The extent to which the applicant demonstrates and documents an 
understanding of the priorities for the public health system, the unmet 
needs of the association or organization, and the opportunities and 
barriers that exist among the target audience(s).

C. Program Objectives (15%)

    The extent to which the proposed objectives are specific, 
measurable, time-phased, and consistent with the purpose of the program 
announcement, the identified priorities, and the applicant 
organization's overall mission.

D. Quality of Plan (20%)

    The strength of the applicant's plan for conducting program 
activities and the likelihood that the proposed plans will adequately 
address the priorities.
E. Organizational Experience (15%)

    The extent to which the applicant can demonstrate existing support 
for partnership activities and collaboration with CDC, other 
associations and organizations, and official public health agencies.

F. Evaluation Plan (15%)

    The extent to which the evaluation plan measures the achievement of 
program objectives and monitors the implementation of proposed 
activities or the commitment to implement a collaboratively developed 
evaluation plan.

G. Budget Justification (not scored)

    The budget will be evaluated for the extent to which it is 
reasonable, clearly justified, and consistent with the intended use of 
cooperative agreement funds. Applicants are also requested to present 
an estimate (percentage) of their total request budgeted for each 
identified priority.
II. Predecisional Site Visits
    Site visits may be conducted before CDC makes final funding 
decisions. Only those associations and organizations with high-ranking 
applications may be visited. During the visit, CDC staff will meet with 
project staff, a representative of the board of directors, and other 
applicant principals to assess the applicant's ability to implement the 
proposed program, review the application and program plans for current 
or planned activities, and determine the special programmatic 
conditions and technical assistance requirements of the applicant.

Executive Order 12372 Review

    This program is not subject to the Executive Order 12372 review.

Public Health System Reporting Requirements

    This program is not subject to the Public Health System Reporting 
Requirements.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance Number is 93.283.

Other Requirements

    A. Confidentiality of Records: All identifying information obtained 
in connection with the provision of services to any person in any 
program that is being carried out through a cooperative agreement made 
under this announcement may not be disclosed unless required by a law 
of a State or political subdivision or unless written, voluntary 
informed consent is provided by persons who receive services.
    B. OMB Review: Projects/activities that involve the collection of 
information from 10 or more individuals and funded by the cooperative 
agreement will be subject to review by the Office of Management and 
Budget under the Paperwork Reduction Act.

Application and Submission Deadline

Preapplication Letter of Intent
    A non-binding letter of intent-to-apply is required from potential 
applicants. An original and two copies of the letter should be 
submitted to the Grants Management Branch, CDC at the address for Ron 
Van Duyne given below. It should be postmarked no later than January 
15, 1997. The letter should identify the announcement number, name of 
the Principal Investigator, and specify the activity(ies) to be 
addressed by the proposed project. The letter of intent does not 
influence review or funding decisions, but it will enable CDC to plan 
the review more efficiently, and will ensure that each applicant 
receives timely and relevant information prior to application 
submission.
Application
    The original and two copies of the application PHS Form 5161-1 
(Revised 7/92, OMB Control Number 0937-0189) must be submitted to Ron 
Van Duyne, Grants Management Officer, Grants Management Branch, 
Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 321, Mailstop E-
13, Atlanta, GA 30305, on or before February 14, 1997.
    1. Deadline: Applications meet the deadline if they are either:
    (a) Received on or before the deadline date; or
    (b) Sent on or before the deadline date and received in time for 
submission to the objective review group. (Applicants must request a 
legibly dated U.S. Postal Service postmark or obtain a legibly dated 
receipt from a commercial carrier or U.S. Postal Service. Private 
metered postmarks will not be acceptable as proof of timely mailing.)
    2. Late Applications: Applications which do not meet the criteria 
in 1. (a) or 1. (b), above are considered late applications. Late 
applications will not be considered and will be returned to applicants.

Where to Obtain Additional Information

    A complete program description, information on application 
procedures, an application package, and business management technical 
assistance may be obtained from David Elswick, Grants Management 
Specialist, Grants

[[Page 66052]]

Management Branch, Procurement and Grants Office, Centers for Disease 
Control and Prevention (CDC), 255 East Paces Ferry Road, NE., Room 321, 
Mailstop E-13, Atlanta, GA 30305, telephone (404) 842-6521, Internet 
address: DCE[email protected]. Programmatic technical assistance may 
be obtained from Deane Johnson, Division of Public Health Systems, 
Public Health Practice Program Office, Centers for Disease Control and 
Prevention (CDC), 1600 Clifton Road, NE., Mailstop K-39, Atlanta, GA 
30333, telephone (770) 488-2495.
    Please refer to Announcement 711 when requesting information and 
submitting an application.
    Potential applicants may obtain a copy of ``Healthy People 2000'' 
(Full Report, Stock No. 017-001-00474-0) or ``Healthy People 2000'' 
(Summary Report, Stock No. 017-001-00473-1) referenced in the 
INTRODUCTION through the Superintendent of Documents, Government 
Printing Office, Washington, DC 20402-9325, telephone (202) 512-1800.

    Dated: December 10, 1996
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 96-31822 Filed 12-13-96; 8:45 am]
BILLING CODE 4163-18-P