[Federal Register Volume 62, Number 32 (Tuesday, February 18, 1997)]
[Notices]
[Pages 7241-7245]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-3892]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration


Special Project Grants and Cooperative Agreement; Maternal and 
Child Health (MCH) Services; Community Integrated Service Systems 
(CISS) Set-Aside Program

AGENCY: Health Resources and Services Administration (HRSA).

ACTION: Notice of availability of funds.

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SUMMARY: The HRSA announces that approximately $2.3 million in fiscal 
year (FY) 1997 funds will be available for grants for Maternal and 
Child Health (MCH) Community Integrated Service Systems grants to 
support strategies for reducing infant mortality and improving the 
health of mothers and children through development and expansion of 
successful community integrated service systems. These community 
integrated service systems are public-private partnerships of community 
health and other related organizations and individuals working 
collaboratively to use community resources to address community-
identified health problems. Awards are made under the program authority 
of section 502(b)(1)(A) of the Social Security Act, the CISS Federal 
Set-Aside Program. Within the HRSA, CISS projects are administered by 
the Maternal and Child Health Bureau (MCHB).
    Of the approximately $9.8 million available for all CISS activities 
in FY 1997, about $2.3 million will be available to support 
approximately 33 new and competing renewal projects at an average of 
about $69,700 per award for a one-year period. The remaining funds will 
be used to continue existing CISS projects and for other activities in 
support of overall CISS program goals. The actual amounts available for 
awards and their allocation may vary, depending on unanticipated 
program requirements and the volume and quality of applications. Awards 
are made for grant periods which generally run from 1 up to 4 years in 
duration. Funds for CISS awards are appropriated by Public Law 104-208.
    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of Healthy People 
2000, a PHS-led national activity for setting priority areas. The MCH 
Block Grant Federal Set-Aside Program addresses issues related to the 
Healthy People 2000 objectives of improving maternal, infant, child and 
adolescent health and developing service systems for children with 
special health care needs. Potential applicants may obtain a copy of 
Healthy People 2000 (Full Report: Stock No. 017-001-00474-0) or Healthy 
People 2000 (Summary Report: Stock No. 017-001-00473-1) through the 
Superintendent of Documents, Government Printing Office, Washington, DC 
20402-9325 (telephone: 202-512-1800).
    The PHS strongly encourages all grant recipients to provide a 
smoke-free workplace and promote the non-use of all tobacco products. 
In addition, Public Law 103-227, the Pro-Children Act of 1994, 
prohibits smoking in certain facilities (or in some cases, any portion 
of a facility) in which regular or routine education, library, day 
care, health care or early childhood development services are provided 
to children.

ADDRESSES: Federal Register notices and application guidance for MCHB 
programs are available on the World Wide Web via the Internet at 
address: http://www.os.dhhs.gov/hrsa/mchb. Click on the file name you 
want to download to your computer. It will be saved as a self-
extracting (Macintosh or) WordPerfect 5.1 file. To decompress the file 
once it is downloaded, type in the file name followed by a . 
The file will expand to a WordPerfect 5.1 file.
    For applicants for CISS grants and cooperative agreements who are 
unable to access application materials electronically, a hard copy may 
be obtained from the HRSA Grants Application Center. Applicants for 
CISS research grants will use PHS form 398, approved by the Office of 
Management and Budget (OMB) under control number 0925-0001. Applicants 
for all other CISS awards will use revised PHS form 5161-1, approved 
under OMB clearance number 0937-0189. Requests should specify the 
category or categories of activities for which an application is 
requested so that the appropriate forms, information and materials may 
be provided. The Center may be contacted by: Telephone Number: 1-888-
300-HRSA, FAX Number: 301-309-0579, E-mail Address: 
[email protected]. Completed applications should be returned to: 
Grants Management Officer, HRSA Grants Application Center, 40 West Gude 
Drive, Suite 100, Rockville, Maryland 20850. Please indicate the 
appropriate CFDA # for the application being submitted (see table 
below).

DATES: Potential applicants are invited to request application packages 
for the particular program category in which they are interested, and 
to submit their applications for funding consideration. Deadlines for 
receipt of applications differ for the several categories of grants. 
These deadlines are as follows:

    Competitive Grants for Community Integrated Service Systems (CISS) Federal Set-Aside Program Anticipated    
                  Deadline, Award, Funding, and Project Period Information, by Category FY 1997                 
----------------------------------------------------------------------------------------------------------------
                                                                      Est.                             Project  
           CFDA No.             Funding source      Application     number of      Est. amounts         period  
                                   category          deadline        awards          available         (years)  
----------------------------------------------------------------------------------------------------------------
93.110(V)....................  Healthy           April 17, 1997..          10  $500,000............            5
                                Tomorrows                                                                       
                                Partnership for                                                                 
                                Children.                                                                       
93.110(AN)...................  CISS Research     July 1, 1997....           2  600,000.............            5
                                Grants.                                                                         
93.110(AP)...................  Maternal and      May 13, 1997....           1  200,000.............            5
                                Child Health                                                                    
                                Provider                                                                        
                                Partnership                                                                     
                                Cooperative                                                                     
                                Agreement.                                                                      

[[Page 7242]]

                                                                                                                
93.110(AR)...................  CISS Local/State  April 30, 1997..          20  1 million...........            4
                                Community                                                                       
                                Organization                                                                    
                                Grants.                                                                         
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    Applications will be considered to have met the deadline if they 
are either: (1) Received on or before the deadline date, or (2) 
postmarked on or before the deadline date and received in time for 
orderly processing. Applicants should request a legibly dated receipt 
from a commercial carrier or the U.S. Postal Service, or obtain a 
legibly dated U.S. Postal Service postmark. Private metered postmarks 
will not be accepted as proof of timely mailing. Late applications will 
be returned to the applicant.

FOR FURTHER INFORMATION CONTACT: Requests for technical or programmatic 
information should be directed to the contact persons identified below 
for each category covered by this notice. Requests for information 
concerning business management issues should be directed to: Sandra 
Perry, Grants Management Officer (GMO), Maternal and Child Health 
Bureau, 5600 Fishers Lane, Room 18-12, Rockville, Maryland 20857, 
telephone: 301-443-1440.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

    Public Law 101-239, the Omnibus Budget Reconciliation Act of 1989 
(OBRA 1989) provided for a new set-aside program under the MCH Block 
Grant that would be activated when the annual appropriation for title V 
exceeds $600 million. This has become known as the CISS program. The 
program seeks to reduce infant mortality and improve the health of 
mothers and children, including those living in rural areas and those 
having special health care needs, through project support for 
development and expansion of strategies which have proved successful in 
helping communities to achieve integrated service systems.
    OBRA 1989 also provided the conceptual framework for strengthening 
Federal-State partnerships under the MCH Block Grant. States are now 
expected to work with their Federal and local partners to promote 
development of comprehensive, community-based systems of health and 
related services which can assure family-centered, culturally 
competent, coordinated care for children and their families.
    CISS Phase I (FY 92-95) featured support of demonstrations of one 
or more Congressionally-designated service delivery strategies: Home 
visiting activities; provider participation in publicly funded 
programs; one stop shopping service integration projects; not-for-
profit hospital/community based initiatives; MCHB projects serving 
rural populations; and outpatient and community based program 
alternatives to inpatient institutional care for children with special 
health care needs. These service delivery demonstrations served as 
focal points or platforms from which linkages were established with a 
variety of agencies, laying the foundation for a local system of 
delivery of services.
    Initial CISS grants funded in FY 1992 were required to use at least 
one of the above-listed six strategies to achieve program objectives. 
In FY 1993, CISS grants were directed toward developing and/or 
expanding successful community integrated service systems using at 
least one of the six strategies. Priority was given to projects which 
could demonstrate a high likelihood of having continuing support beyond 
the federal grant period and strong community based public/private 
organizational collaboration, including participation of the local 
county/municipal health departments, the State MCH and CSHCN programs, 
and, where they exist, community and migrant health centers.
    In FY 1994 and 1995 CISS grants supported Home Visiting for At-Risk 
Families (HVAF), in collaboration with the Administration for Children 
and Families'' (ACF) Family Preservation and Support Program. The 
purpose of the CISS/HVAF was to assist State MCH programs to emphasize 
the home visiting model as an important component of care. The CISS/
HVAF grants were used to support development of an enhanced health 
component in the ACF's Five Year State Plans for Family Preservation 
and Family Support Services.
    Prior to establishing the CISS-Phase II program priorities for FY 
1996 and beyond, feedback was solicited from members of the MCH 
community, the 41 current CISS grantees, and the MCH-ACF Technical 
Assistance Group, a working group of senior State and Federal-level 
child health, welfare, social services, and child care officials. In FY 
1996, MCHB began CISS-Phase II, using a variety of approaches to 
implement the local systems integration activities developed in Phase 
I.
    Again in FY 1997, CISS funds will support local systems integration 
activities. CISS funds will also be available in FY 1997 for Community-
Based Intervention Research Grant projects, which seek to generate new 
knowledge on early intervention services models and on how to integrate 
these models into existing systems of care at the community level while 
sustaining the essential nature and demonstrated effectiveness of the 
original prototypes. In addition, FY 1997 CISS funds will be available 
to fund Healthy Tomorrows projects, which encourage support from the 
private sector to form community-based partnerships to coordinate 
preventive health resources for pregnant women, infants, and children. 
CISS funds will also support a cooperative agreement aimed at enhancing 
private-public partnerships to restructure and improve perinatal health 
services in communities.

Program Goal

    The goal of the CISS program is to enhance development of service 
systems at the community level capable of addressing the physical, 
psychological, social well-being, and related needs of pregnant women, 
infants, and children, including children with special health care 
needs and their families. CISS projects assist communities to better 
meet consumer-identified needs, fill gaps in services, reduce 
duplication of effort, coordinate activities, increase availability of 
services, improve efficiency, and enhance quality of care. Programs 
must be developed in collaboration and coordination with the State MCH 
Services Block Grant programs and State efforts in community systems 
development. Where appropriate, programs should be coordinated with 
other HRSA-funded programs that build community infrastructure in the 
respective States.

[[Page 7243]]

Eligible Applicants

    Any public or private entity, including an Indian tribe or tribal 
organization (as defined at 25 U.S.C. 450b), is eligible to apply for 
grants or cooperative agreements for project categories covered by this 
announcement. As noted in the Funding Categories section below, based 
on the subject matter of particular categories or subcategories, 
applications may be encouraged from applicants with a specified area of 
expertise. In addition, special funding considerations may apply to 
certain categories or subcategories.

Funding Categories

    CISS funds are available for 4 categories of projects this year: 
Healthy Tomorrows Partnerships for Children; CISS Research Grants; 
Maternal and Child Health Provider Partnership Cooperative Agreement; 
and CISS Local/State Community Organization Grants.

Category 1: Healthy Tomorrows Partnership for Children (CFDA #93.110V)

     Narrative Description of this Competition: This program 
supports projects for mothers and children that improve access to 
health services and utilize preventive strategies. The initiative 
encourages additional support from the private sector and from 
foundations to form community-based partnerships to coordinate health 
resources for pregnant women, infants, and children. Proposals are 
invited in the following priority program areas: (1) Local initiatives 
that are community-based, family-centered, comprehensive and culturally 
relevant and improve access to health services for infants, children, 
adolescents, or CSHCN; and (2) initiatives which show evidence of a 
capability to meet cost participation goals for securing funds for the 
second and sequential years of the project.
     Estimated Amount of this Competition: $500,000.
     Number of Expected Awards: 10.
     Funding Priorities and/or Preferences: In the interest of 
equitable geographical distribution, special consideration for funding 
will be given to projects from States without a currently funded 
Healthy Tomorrows project. These States are identified in the 
application guidance.
     Evaluation Criteria: See Criteria for Review; application 
guidance materials will specify final criteria.
     Application Deadlines: April 17, 1997.
     Contact Person: Latricia C. Robertson, telephone: 301-443-
8041.

Category 2: CISS Community-Based Intervention Research (CFDA #110AN)

     Narrative Description of this Competition: The purpose of 
these projects is to support research on CISS-sponsored early 
intervention services programs within the context of developing and 
expanding local service delivery systems. The intent is to generate new 
knowledge on early intervention services models and on how to integrate 
these models into existing systems of care at the community level while 
sustaining the essential nature and demonstrated effectiveness of the 
original prototypes.
     Eligible Organizations: Eligible applicants are public or 
nonprofit institutions of higher learning and public or nonprofit 
private agencies and organizations engaged in research or in maternal 
and child health or children with special health care needs programs.
     Estimated Amount of this Competition: $600,000.
     Number of Expected Awards: 2.
     Evaluation Criteria: See Criteria for Review; application 
guidance will specify final review criteria.
     Application Deadline: July 1, 1997.
     Contact Person: Gontran Lamberty, Dr. P.H., telephone: 
301-443-2190.

Category 3: Maternal and Child Health Provider Partnership (CFDA 
#93.110AP)

     Narrative Description of this Competition: This 
cooperative agreement will support an effort to encourage private 
sector involvement and strengthen private-public partnerships to 
restructure and improve perinatal health services in communities and 
States and to improve coordination of and access to community health 
resources for women of reproductive age and infants. The awardee will 
be expected to analyze the current circumstances and obstacles to 
providers in the delivery of maternal and infant health services, 
develop strategies to improve maternal and infant health status and 
service systems through collaboration with national and State public 
health organizations, and disseminate and communicate concerns and 
information pertaining to the issues and strategies employed to their 
members and to other national organizations.
    It is anticipated that substantial Federal programmatic involvement 
will be required in this cooperative agreement. This means that after 
award, awarding office staff provide technical assistance and guidance 
to, or coordinate and participate in, certain programmatic activities 
of award recipients beyond their normal stewardship responsibilities in 
the administration of grants. Federal involvement may include, but is 
not limited to, planning, guidance, coordination and participation in 
programmatic activities. Periodic meetings, conferences, and/or 
communications with the award recipient are held to review mutually 
agreed upon goals and objectives and to assess progress. Additional 
details on the scope of Federal programmatic involvement in cooperative 
agreements, consistent with HRSA grants administration policy, will be 
included in the application guidance for this cooperative agreement.
     Estimated Amount of this competition: $200,000.
     Number of Expected Awards: 1.
     Funding Priorities and/or Preferences: Preference for 
funding will be given to national membership organizations representing 
providers of obstetrical and gynecological services.
     Evaluation Criteria: See Criteria for Review; application 
guidance materials will specify final criteria.
     Application Deadline: May 13, 1997.
     Contact Person: Ann M. Koontz, Dr.P.H., telephone: 301-
443-6327.

Category 4: CISS Local/State Community Organization Grants (CFDA 
#93.110AR)

    These grants will support community organization activities in two 
areas: (1) Local level agencies; and (2) State MCH agencies. Funds may 
be used to hire staff to assist in consortium building and to function 
as community organizers, to help formulate a plan for integrated 
service systems, to obtain and/or provide technical assistance, and to 
convene community or State networking meetings for information 
dissemination and replication of systems integration programs.
 Subcategory A: Local Level Community Organization Grants
     Narrative Description of this Competition: The purpose of 
these grants is to provide direct support to local communities to array 
resources in the most beneficial form to promote consortium building, 
creation of integrated service systems, or replication of systems 
integration programs at the local level. While not designed to support 
direct service delivery, these monies may be used to modify functions 
of existing service organizations to better complement each other. The 
specific approach is at the discretion of each community. Because CISS 
projects are intended to facilitate

[[Page 7244]]

the development of systems of services in communities, projects must be 
consistent with State systems development efforts.
     Estimated Amount of this Competition: $500,000.
     Number of Expected Awards: 10.
     Funding Priorities and/or Preferences: Preference for 
funding of these grants will be given to local communities. In the 
interest of equitable geographical distribution, special consideration 
for funding will be given to projects from communities without a 
currently-funded CISS project.
     Application Deadline: April 30, 1997.
     Contact Person: Joseph A. Zogby, M.S.W., telephone: 301-
443-4393.
 Subcategory B: State Community Organization Grants
     Narrative Description of this Competition: The purpose of 
these grants is to support strengthened ties between MCHB's community 
and State-level system development initiatives since FY 1992, thus 
reinforcing the benefits of the substantial investment in State and 
local infrastructure-building represented by ongoing SPRANS State 
Systems Development Initiative (SSDI) grants as well as CISS 
initiatives. State networking activities which may be supported by 
these grants include: Providing technical assistance to community and 
local organizations needing help in systems development; convening 
statewide meetings; and disseminating and replicating successful local/
community strategies.
     Estimated Amount of this Competition: $500,000.
     Number of Expected Awards: 10.
     Funding Priorities and/or Preferences: Preference for 
funding of these grants will be given to State MCH agencies.
     Application Deadline: April 30, 1997.
     Contact Person: Joseph A. Zogby, M.S.W., telephone: 301-
443-4393.

Special Concerns

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

Evaluation Protocol

    An MCH discretionary project, including a CISS, is expected to 
incorporate a carefully designed and well planned evaluation protocol 
capable of demonstrating and documenting measurable progress toward 
achieving the project's stated goals. The protocol should be based on a 
clear rationale relating the project activities, the project goals, and 
the evaluation measures. Wherever possible, the measurements of 
progress toward goals should focus on health outcome indicators, rather 
than on intermediate measures such as process or outputs. A project 
lacking a complete and well-conceived evaluation protocol as part of 
the planned activities may not be funded.

Project Review and Funding

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

Criteria for Review

    The criteria which follow are derived from MCH project grant 
regulations at 42 CFR Part 51a or from HRSA administrative policies 
that apply to MCHB discretionary projects. These criteria are used, as 
pertinent, to review and evaluate applications for awards under all 
CISS grant and cooperative agreement categories announced in this 
notice. Application guidance materials specify final criteria.

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

[[Page 7245]]

and program priorities specified elsewhere in this notice.

Funding of Approved Applications

    Final funding decisions for SPRANS research and training grants are 
the responsibility of the Director, MCHB. In considering scores for the 
ranking of approved applications for funding, preferences may be 
exercised for groups of applications, e.g., applications from 
geographical areas without previously funded projects in particular 
category vs. applications from with previously funded projects. Within 
any category of approved projects, the score of an individual project 
may be favorably adjusted if the project addresses specific priorities 
identified in this notice. In addition, special consideration in 
assigning scores may be given by reviewers to individual applications 
that address areas identified in this notice as meriting special 
consideration.

Executive Order 12372

    The MCH Federal set-aside program has been determined to be a 
program which is not subject to the provisions of Executive Order 12372 
concerning intergovernmental review of Federal programs.

    The OMB Catalog of Federal Domestic Assistance number is 93.110.

    Dated: February 6, 1997.
Ciro V. Sumaya,
Administrator.

[FR Doc. 97-3892 Filed 2-14-97; 8:45 am]
BILLING CODE 4160-15-P