[Federal Register Volume 62, Number 120 (Monday, June 23, 1997)]
[Notices]
[Pages 33876-33888]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-16310]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Announcement 780]


State Injury Intervention and Surveillance Program; Notice of 
Availability of Funds for Fiscal Year 1997

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 1997 funds for a cooperative agreement 
program for State injury intervention and surveillance programs, 
focused in four topic areas: Prevention of Unintentional Injuries 
(bicycle helmet promotion (Part IA1), prevention of residential fire-
related injuries (Part IA2)); Trauma Care Systems (Part IB); Emergency 
Department Injury Surveillance (Part IC); and Basic Injury Program 
Development (Part II).
    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 to improve the quality of life. 
This announcement is related to the priority areas of Unintentional 
Injuries, Violent and Abusive Behavior, and Surveillance and Data 
Systems. (For ordering a copy of ``Healthy People 2000,'' see the 
section Where to Obtain Additional Information.)

Programmatic Assistance--Topic Specific Telephone Conferences

    During the week of July 7-11, 1997, a series of five, one-hour 
each, topic-specific, programmatic assistance telephone conferences 
will be arranged by CDC program staff. To receive the exact date, time, 
and call-in information, please contact the appropriate CDC program 
individual (see where to Obtain Additional Information section).

Authority

    This program is authorized under sections 301, 317, 391, and 394A 
of the Public Health Service Act [42 U.S.C. 241, 247b, 280b, and 280b-
3] as amended.

Smoke-Free Workplace

    CDC strongly encourages all cooperative agreement recipients to 
provide a smoke-free workplace and to 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.

[[Page 33877]]

Eligible Applicants

    Eligible applicants are the official State public health agencies 
or their bona fide agents. This includes the District of Columbia, 
American Samoa, the Commonwealth of Puerto Rico, the Virgin Islands, 
the Federated States of Micronesia, Guam, the Northern Mariana Islands, 
the Republic of the Marshall Islands, and the Republic of Palau.

    Note: Effective January 1, 1996, Public Law 104-65 states that 
an organization described in section 501(c)(4) of the Internal 
Revenue Code of 1986 which engages in lobbying activities shall not 
be eligible to receive Federal funds constituting an award, grant 
(cooperative agreement), contract, loan, or any other form.

Availability of Funds

    Approximately $3,290,000 is available in FY 1997 to fund up to 
nineteen new and competing continuation awards:

Parts IA1 and IA2

    Approximately $1,750,000 is available to fund up to ten awards in 
the areas of: (1) Bicycle Helmet Promotion, and (2) Residential Fire 
Injury Prevention. It is expected that the average award will be 
$175,000, ranging from $150,000 to $185,000.

Part IB

    Approximately $490,000 is available to fund up to two awards for 
Trauma Care System development. It is expected that the average award 
will be $245,000, ranging from $230,000 to $260,000.

Part IC

    Approximately $750,000 is available to fund up to three awards for 
development and enhancement of Emergency Department Injury Surveillance 
Programs. It is expected that the average award will be $250,000, 
ranging from $225,000 to $275,000.

Part II

    Approximately $300,000 is available to fund up to four awards for 
Basic Injury Program Development. It is expected that the average award 
will be $75,000, ranging from $70,000 to $80,000.
    States applying for Unintentional Injury Prevention Programs (Parts 
IA1 and IA2) may apply for Bicycle Helmet Promotion (Part IA1) funding 
or Residential Fire Injury Prevention (Part IA2) funding, but not both.
    States applying for Basic Injury Program Development (Part II) may 
not apply for any Part I topics.
    Projects are expected to begin on or about September 30, 1997, and 
will be made for a 12-month budget period within a project period of up 
to 3 years. Funding estimates may vary and are subject to change.
    Continuation awards within the project period will be made on the 
basis of satisfactory progress and the availability of funds.

    Note: At the request of the applicant, Federal personnel may be 
assigned in lieu of a portion of the financial assistance.

    Funding Preferences: During the selection process, CDC will make 
every effort to ensure a balanced geographic distribution, including 
urban and rural States, for each topic area.

Use of Funds

    Funds may be used for personnel services, supplies, equipment, 
travel, subcontracts, and services directly related to project 
activities. Project funds cannot be used to supplant other existing 
funds for planning, implementation or surveillance activities, for 
construction costs, or to lease or purchase buildings, office space, or 
vehicles.

Restrictions on Lobbying

    Applicants should be aware of restrictions on the use of HHS funds 
for lobbying of Federal or State legislative bodies. Under the 
provisions of 31 U.S.C. Section 1352 (which has been in effect since 
December 23, 1989), recipients (and their subtier contractors) are 
prohibited from using appropriated Federal funds (other than profits 
from a Federal contract) for lobbying Congress or any Federal agency in 
connection with the award of a particular contract, grant, cooperative 
agreement, or loan. This includes grants/cooperative agreements that, 
in whole or in part, involve conferences for which Federal funds cannot 
be used directly or indirectly to encourage participants to lobby or to 
instruct participants on how to lobby.
    In addition, the FY1997 HHS Appropriations Act, which became 
effective October 1, 1996, expressly prohibits the use of 1997 
appropriated funds for indirect or ``grass roots'' lobbying efforts 
that are designed to support or defeat legislation pending before State 
legislatures. This new law, Section 503 of Pub. L. No. 104-208, 
provides as follows:

    Sec. 503(a)  No part of any appropriation contained in this Act 
shall be used, other than for normal and recognized executive-
legislative relationships, for publicity or propaganda purposes, for 
the preparation, distribution, or use of any kit, pamphlet, booklet, 
publication, radio, television, or video presentation designed to 
support or defeat legislation pending before the Congress, * * * 
except in presentation to the Congress or any State legislative body 
itself.
    (b) No part of any appropriation contained in this Act shall be 
used to pay the salary or expenses of any grant or contract 
recipient, or agent acting for such recipient, related to any 
activity designed to influence legislation or appropriations pending 
before the Congress or any State legislature.

Department of Labor, Health and Human Services, and Education, and 
Related Agencies Appropriations Act, 1997, as enacted by the Omnibus 
Consolidated Appropriations Act, 1997, Division A, Title I, Section 
101(e), Pub. L. No. 104-208 (September 30, 1996).

Prohibition on Use of CDC Funds for Certain Gun Control Activities

    The Departments of Labor, Health and Human Services, and Education, 
and Related Agencies Appropriations Act, 1997 specifies that: ``None of 
the funds made available for injury prevention and control at the 
Centers for Disease Control and Prevention may be used to advocate or 
promote gun control.''
    Anti-Lobbying Act requirements prohibit lobbying Congress with 
appropriated Federal monies. Specifically, this Act prohibits the use 
of Federal funds for direct or indirect communications intended or 
designed to influence a Member of Congress with regard to specific 
Federal legislation. This prohibition includes the funding and 
assistance of public grassroots campaigns intended or designed to 
influence Members of Congress with regard to specific legislation or 
appropriation by Congress.
    In addition to the restrictions in the Anti-Lobbying Act, CDC 
interprets the new language in the CDC's 1997 Appropriations Act to 
mean that CDC's funds may not be spent on political action or other 
activities designed to affect the passage of specific Federal, State, 
or local legislation intended to restrict or control the purchase or 
use of firearms.

Background and Definitions for Topic Areas

Part IA1: Bicycle Helmet Promotion

    Bicycle riding is a popular American past time. An estimated 66.9 
million Americans ride bicycles; indeed, about 29 percent of U.S. 
households have one or more bicyclists. Bicycle riding also has 
accompanying risks. Each year, an average of 879 persons die from 
injuries caused by bicycle crashes, and 592,000 persons are treated in 
emergency departments (EDs) for injuries from bicycling. Head injury is 
the most common cause of death and serious disability in bicycle-
related crashes; head injuries are involved in about 60

[[Page 33878]]

percent of the deaths, and 30 percent of the bicycle-related ED visits. 
Many of these nonfatal head injuries produce lifelong disability from 
irreversible brain damage. Societal costs for bicycle-related head 
injuries exceed $2 billion annually.
    American children, in particular, are avid bicyclists--an estimated 
33 million children ride bicycles nearly 10 billion hours each year. 
Unfortunately, an average of 384 children die annually from bicycle 
crashes, and 450,000 more are treated in EDs for bicycle-riding related 
injuries.
    Bicycle helmets are a proven intervention that reduce the risk of 
bicycle-related head injury by about 80 percent, yet bicycle helmets 
are not worn by most riders. Only 19 percent of adults and 15 percent 
of children use helmets all or most of the time while cycling. If all 
bicyclists wore helmets, from 335-393 deaths and 119,000-140,000 ED-
treated head injuries could be prevented each year. Accordingly, a 
Healthy People 2000 goal is 50 percent bicycle helmet use by the Year 
2000. To promote this goal, CDC has published recommendations that 
urged: (1) Helmets be worn by persons of all ages when bicycling, (2) 
riders wear helmets whenever or wherever they ride, (3) helmets should 
meet test standards, and (4) States and communities implement 
strategies to increase helmet use, including education and promotion, 
legislation, enforcement, and program evaluation.
    For Bike Helmet Promotion Model Program and further background 
information, see the Where to Obtain Additional Information section.

Part IA2: Residential Fire Injury Prevention

    In 1995, there were an estimated 414,000 home fires in the United 
States, which killed 3,640 individuals and injured an additional 18,650 
people. Direct property damage caused by these fires exceeded $4.2 
billion. In 1994, the monetary equivalent of all fire deaths and 
injuries, including deaths and injuries to fire fighters, was estimated 
at $14.8 billion.
    Residential fire deaths occur disproportionately in the 
southeastern States. They also occur disproportionately during the 
winter months of December--February, a period during which more than 
one-third of home fires occur, compared to one-sixth in the summer 
months of June-August. Many subgroups within the population remain 
highly vulnerable to fire morbidity and mortality. The rate of death 
due to fire is higher among the poor, minorities, children under age 5, 
adults over age 65, low-income communities in remote rural areas or in 
poor urban communities, and among individuals living in manufactured 
homes built before 1976, when the U.S. Department of Housing and Urban 
Development construction safety standards became effective. Other risk 
factors for fire-related deaths include:
     Inoperative smoke detectors,
     Careless smoking,
     Abuse of alcohol or other drugs,
     Incorrect use of alternative heating sources including 
usage of devices inappropriate or insufficient for the space to be 
heated,
     Inadequate supervision of children,
     Insufficient fire safety education.
    The majority of fire-related fatalities occur in fires that start 
at night while occupants are asleep, a time when effective detection 
and alerting systems are of special importance. Operable smoke 
detectors on every level provide the residents of a burning home with 
sufficient advance warning for escape from nearly all types of fires. 
If a fire occurs, homes with functional smoke detectors are half as 
likely to have a death occur as homes without smoke detectors. As a 
result, operable residential smoke detectors can be highly effective in 
preventing fire-related deaths. Accordingly, a Healthy People 2000 
objective is the reduction of residential fire deaths to no more than 
1.2 per 100,000 people by the Year 2000.
    For Residential Fire Injury Prevention Programs the definition for 
high-risk target populations is a community or geographic area known to 
have: (1) A high prevalence of residential fire deaths, (2) a low 
prevalence of functional residential smoke detectors, (3) a composition 
of primarily low-income residents, or (4) a high proportion of rented 
residential units.
    For Residential Fire Injury Prevention Model Program and further 
background information, see the Where to Obtain Additional Information 
section.

Part IB: Trauma Care System Development

    A trauma care system (TCS) is an organized, hierarchical approach 
to trauma care in which the medical needs of individual trauma patients 
are optimally matched to the resources available in a defined 
geographic region. In a TCS, a lead agency categorizes hospitals on the 
basis of their trauma care capabilities, designated trauma centers 
provide 24 hour access to the highest level of care, and prehospital 
field protocols are used to triage injured patients to the most 
appropriate hospital. The finding that 30 percent to 35 percent of 
trauma patient deaths are preventable in conventional trauma care has 
mobilized support for TCS planning and implementation. Studies showing 
up to a 50 percent reduction in preventable trauma deaths when a TCS is 
implemented provide compelling evidence of TCS effectiveness.
    Despite the proven effectiveness of TCSs, in 1993 only five States 
satisfied established criteria for a complete TCS, a modest increase 
from two States that met the criteria in 1988. Financial constraints 
are the major barrier to TCS implementation. Prohibitively high start-
up costs and operating expenses deter emergency medical services (EMS) 
agencies from serving as the lead agencies for TCSs, and concerns about 
revenue loss impede greater TCS participation by acute care hospitals 
and trauma care professionals. Other impediments to TCS implementation 
include organizational and political barriers, among the most important 
of which is an increasingly competitive health care market that makes 
it difficult to establish integrated systems of care. Major planning, 
publicity, and educational efforts are needed to develop or enhance a 
TCS, along with ongoing coordination of prehospital and hospital 
services and continuous quality improvement efforts.
    Baseline and follow-up studies of trauma incidence and outcomes are 
instrumental in planning, implementing, and evaluating a TCS. Among the 
most useful data sources are trauma registries, hospital discharge 
data, vital statistics, autopsy records, emergency medical services 
(EMS)run reports, and surveys that assess hospital trauma care 
capabilities. Among the most informative outcome studies are 
preventable trauma death audits using expert review panels, comparisons 
of expected and observed mortality using trauma registry data and 
predictive mathematical models, and studies of death rates among trauma 
patients based on their hospital discharge diagnoses and other data. A 
variety of approaches are used to evaluate structural aspects of TCSs 
and patient care processes before and after TCS implementation. Among 
the most informative of these studies are surveys that identify whether 
specific TCS components are in place and process indicators that focus 
on the timeliness and appropriateness of trauma care.
    For Trauma Care System Model Program and further background 
information, see the Where to Obtain Additional Information section.

[[Page 33879]]

Part IC: Emergency Department Injury Surveillance

    Public health professionals need adequate information to develop, 
implement, and evaluate prevention programs, and decision makers need 
adequate information to develop policies to prevent injuries. Public 
health surveillance of injuries should provide data to make sound 
policy decisions and to plan prevention strategies. Injury surveillance 
should: (1) Provide quantitative estimates of injury mortality, 
morbidity, and disability; (2) detect clusters of injury events; (3) 
identify risk factors for injury events; (4) stimulate more focused 
epidemiologic research; (5) help define costs associated with injuries; 
and (6) help determine the effectiveness of injury prevention and 
control programs.
Mortality Data
    Relative to other sources, fatal injury data sources are the most 
well-developed, available and utilized. These include death 
certificates, medical examiner and coroner reports, the FBI's 
Supplemental Homicide Reports, child fatality review system reports, 
and the Fatal Accident and Reporting System (FARS) maintained by the 
National Highway Traffic Safety Administration. Death certificate data 
provide information about both causes and types of fatal injuries 
sustained. State and local programs should have the capacity to use 
their mortality data systems.
Morbidity Data
    Fatal injuries represent only a small portion of the injury problem 
in the United States. The lack of adequate data on nonfatal injuries is 
a serious problem for injury prevention and control. Given the changing 
patterns of health care, hospitalized nonfatal injuries represent a 
smaller portion of the injury burden in the United States. Their 
usefulness to plan injury control programs is less clear. Because of 
this, the ED should be explored for nonfatal injury data. The 
development of standardized hospital emergency department based 
surveillance systems should provide useful data at State and local 
levels. These surveillance systems need to be relevant to local data 
needs (i.e., supporting local injury control efforts) and flexible 
enough to accommodate changing priorities (e.g., the need to estimate 
the risks and benefits of passenger airbags), and have standard case 
definitions and data elements so that data collected can be compared to 
those collected in other jurisdictions, including national samples.
Definitions for Emergency Department Injury Surveillance
    The essential data elements for emergency departments are fully 
defined in CDC's ``Data Elements for Emergency Department Systems'', 
release 1.0. (For ordering a copy see the Where to Obtain Additional 
Information section.)
    Surveillance is the ongoing, systematic collection, analysis, and 
interpretation of health data necessary for designing, implementing, 
and evaluating public health programs.
    Hospital emergency departments are defined as facilities offering 
24-hour emergency medical services affiliated with an acute care 
hospital of six or more beds.
    Non-fatal injuries are defined as consistent with the International 
Classification of Disease (ICD) coding for injury (E800-E999) with the 
specific exclusion of adverse effects of medical care (E870-879) and of 
drugs (E930.0-949.9).
    For Emergency Department Injury Surveillance Model Program and 
further background information, see the Where to Obtain Additional 
Information section.

Part II: Basic Injury Program Development

    Injury is one of the leading causes of death and disability for all 
age groups. It is responsible for more deaths to children and young 
adults than any other cause. Each year, nearly 150,000 people die from 
injuries. Children, minorities, and the elderly are especially at risk. 
Although the greatest cost of injury is in human suffering and loss, 
the financial cost is also staggering. Including direct medical care 
and rehabilitation costs and lost income and productivity, injury costs 
are estimated at more than $224 billion. Without exception, preventing 
injuries costs less than treating them.
    As late as 1989, most State and local public health agencies in 
this country did not have the organizational focus or capacity to 
systematically address injuries as a public health problem or to lead 
their State or community activities in injury prevention and control. 
Currently, each State public health agency, and many of their local 
counterparts, maintains a focus in injury prevention and control. While 
this injury focus is minimal in a portion of these agencies, an 
impressive track record is emerging in this still relatively new field. 
Lessons of importance have been learned. While the locus for injury 
programs in public health agencies is in a variety of organizational 
locations, valuable injury prevention programs are in place and 
accurate surveillance is being conducted. Predictably, public health 
agencies have shown themselves adept at forging relationships with the 
many new partners necessary to address the problem of injuries, and 
these partnerships have successfully crossed traditional zones of 
comfort for both the public health agencies and their partners.
    However, this encouraging level of interest and competence has not 
yet resulted in adequate capacity to address this major public health 
problem in all States. This program will allow State public health 
agencies with minimal injury prevention and control capability to 
establish or strengthen the organizational focus needed to develop 
viable injury prevention and control activities.

Purpose

    The purposes of the cooperative agreements are to enable State 
public health agencies to implement priority injury prevention and 
control activities. The areas of interest are:

Part I

    A. Unintentional Injury Prevention Programs for: 1. Bicycle Helmet 
Promotion Programs (Part IA1), 2. Residential Fire Injury Prevention 
Programs (Part IA2).
    B. Trauma Care System Development Programs (Part IB).
    C. Emergency Department Injury Surveillance Programs (Part IC).

Part II  Basic Injury Program Development Programs (Part II)

    This funding will allow the applicant to establish or strengthen 
injury prevention and control activities in the targeted areas (e.g., 
Trauma Care Systems development). It is expected that programs 
developed or enhanced under this funding will function as a component 
of the public health agency's injury control program (if any exist), 
will coordinate related activities both within the agency and within 
the jurisdiction, and will mobilize, seek input from, and utilize broad 
coalitions.

Four Topic Areas

Part IA1--Bicycle Helmet Promotion

    Bicycle Helmet Promotion Programs are used to promote the use of 
bicycle helmets among high-risk (unhelmeted) 5-12 year-olds. 
(Additional high-risk, age, or demographic groups may be targeted, but 
their inclusion must be justified separately and the 5-12 year-old age 
group must be covered.)
    These programs will establish or strengthen a state-level bicycle 
helmet

[[Page 33880]]

promotion program and allow support for multifaceted local programs 
within the State. State-level programs will collaborate with the State 
Department of Education to promote school-based programs, foster adult 
programs on helmets, and provide public programs to change knowledge, 
attitudes and beliefs, support helmet discounting or giveaways, develop 
helmet-wearing incentive programs, enhance enforcement, encourage 
helmet promotion in the health care delivery setting, and collaborate 
with governmental and civic organizations.
    State programs will foster multifaceted (See Where to Obtain 
Additional Information section) programs at local levels within the 
State. These local programs will include elements such as school-based 
parental programs and public programs to change knowledge, attitudes 
and beliefs, bicycle rodeos, helmet discounting or giveaways, helmet-
wearing incentive programs, enforcement and support of existing 
legislation/regulation, helmet promotion in the health care delivery 
setting, and partnership with civic organizations such as Safe Kids, 
Boy Scouts, etc. Programs will also evaluate the effectiveness of 
strategies for increasing bicycle helmet use (including observing pre- 
and post-program helmet use in the target population.)
    Novel approaches to supplement the elements noted above are 
strongly encouraged.

Part IA2--Residential Fire Injury Prevention

    Residential Fire Injury Prevention Programs are used to allow State 
public health agencies to compare the effectiveness of approaches to 
promoting residential smoke detectors in high-risk populations. The 
focus of the programs is smoke detector installation and maintenance. 
Programs can include home visits--smoke detector installation, and/or 
maintenance of existing detectors- as well as incentive programs that 
provide coupons/discounts for smoke detectors, combined with follow-up. 
Programs will involve educating parents and other care givers, 
children, teachers, policy makers, community leaders, and the general 
public about the importance of residential smoke detectors as an 
effective intervention. Programs may also involve the distribution and 
installation of smoke detectors in selected high risk communities, 
encouraging public policy (nonlegislative), or serving as a resource, 
when requested, as issues arise related to local ordinances requiring 
smoke detector use. Programs will establish or strengthen local smoke 
detector promotion programs which increase current residential smoke 
detector prevalence rates, achieve optimal adequacy of coverage, and 
maintain smoke detector functionality.
    To achieve these goals, programs will support smoke detector 
installation and maintenance programs, develop smoke detector incentive 
programs, provide public education, form broad partnerships that may 
include businesses, governmental agencies, community-based and civic 
organizations, and fire safety personnel, enforce local ordinances, and 
encourage smoke detector promotion in the health care delivery setting.

Part IB--Trauma Care System Development

    This program will enable State public health agencies to enhance 
their role as lead agencies or prospective lead agencies in order to 
plan and take steps toward implementing or improving an inclusive TCS 
in their State or substate region. These programs will develop or 
enhance their State TCS by adding components of an optimal TCS as 
defined in ``A National Plan for Injury Control'' (See Where to Obtain 
Additional Information section), and by evaluating success. 
Specifically, programs will assess the current level of TCS 
development, create plans, and implement or improve components of the 
optimal TCS, regardless of the level of maturity of their existing TCS. 
This program is designed for mature and developing TCSs.

Part IC--Emergency Department Injury Surveillance

    This program is designed to expedite the development of emergency 
department surveillance for injuries in the United States and to 
provide a coordinated approach to improving the quality, comparability, 
and availability of ED data. State public health agencies will develop 
and evaluate or enhance and evaluate a hospital emergency department 
injury data system which can provide E-coded injury data representative 
of all types of emergency department treated nonfatal injuries 
occurring statewide or in a population of one million people or more 
which is representative of the State population. Specifically, programs 
will improve the quality and availability of population-based, hospital 
emergency department nonfatal injury surveillance data for use in 
injury control program planning.

Part II--Basic Injury Program Development

    These program is designed to allow State public health agencies 
with minimal injury prevention and control capability to develop or 
strengthen their organizational focus in prevention and control of 
injuries. State public health agencies will identify a coordinator for 
injury activities, develop a profile of injuries within the State from 
existing data sources, develop an advisory structure to utilize 
collaborative relationships with public and private sector groups, 
organizations, agencies and individuals with interest or expertise in 
injury prevention or control, and develop a priority-driven State plan 
for injury prevention and control.

Cooperative Activities

    In conducting activities to achieve the purposes of this program, 
the recipient will be responsible for the activities under A-E. 
(Recipient Activities), and CDC will be responsible for the activities 
listed under F. (CDC Activities).

A. Recipient Activities: Bicycle Helmet Promotion (Part IA1)

    1. Provide a full-time coordinator with the authority, 
responsibility, and expertise to conduct and manage the state-level 
program and provide technical and evaluation assistance to local 
programs.
    2. If statewide or local legislation requiring bicycle helmet use 
exists, promote its enforcement. Provide evaluation data, when 
requested, for use by legislators considering helmet legislation. When 
requested, serve as a resource as issues arise relating to local 
ordinances requiring bicycle helmet use.
    3. Collaborate with highway safety officials, civic organizations, 
educational groups, employers, health care providers, and others to 
promote statewide bicycle helmet usage.
    4. Collaborate with the State Department of Education to promote 
school-based programs that increase knowledge, affect attitudes and 
beliefs (including students, teachers, and parents), and encourage 
rules to foster helmet use. Encourage school systems to support data 
collection by allowing initial classroom surveys of ridership and 
helmet use by show-of-hands to be conducted.
    5. Encourage parental programs that increase knowledge, affect 
attitudes and beliefs (e.g., in the workplace), provide public 
education (meetings, newsletters, media coverage), support helmet 
discounting or giveaways, develop

[[Page 33881]]

helmet-wearing incentive programs, and encourage helmet promotion in 
the health care delivery setting.
    6. Conduct a multifaceted program and support the development and 
implementation of multifaceted community-based programs to promote the 
use of bicycle helmets.
    7. Evaluate the effectiveness of both the State and local programs, 
including pre- and post-program observed helmet use among the target 
population and, for local programs, observation of at least 100 child 
bicyclists (from at least 4 different sites) in the immediate pre- and 
post-intervention periods.
    8. Designate control communities and conduct observations in these 
communities in order to help differentiate program effects from 
background trends.
    9. Participate in a process of evaluation and improvement in which 
lessons learned are shared with other States implementing bicycle 
helmet promotion programs.

B. Recipient Activities: Residential Fire Injury Prevention (Part IA2)

    1. Provide a full-time coordinator with the expertise, authority, 
and responsibility to manage the state-level program. This individual 
will oversee the development of local area residential smoke detector 
promotion programs and coordinate evaluations of and comparison among 
local interventions conducted within the State during the funding 
cycle. This individual will provide technical and evaluation assistance 
to local programs.
    2. Collaborate with state-level firefighters' associations, fire 
marshals' associations, fire safety coalitions and other grassroots 
organizations (e.g., SAFE KIDS Campaign) which are interested in 
reducing residential fire-related deaths and injuries.
    3. Support the development and implementation of multifaceted 
community-based programs to promote the installation and maintenance of 
smoke detectors in all residential dwellings. Local programs will: (a) 
provide a coordinator who will develop residential smoke detector 
promotion program(s) targeted to a local high-risk group(s) (see Where 
to Obtain Additional Information section); (b) conduct multifaceted 
programs to promote the installation and maintenance of smoke detectors 
in all residential dwellings, including fire-safety education through 
door-to-door canvassing and public education; (c) canvass households 
(at least 400) in the targeted population to determine the 
functionality of residential smoke detectors and install additional 
units as needed, and simultaneously canvass households (at least 400) 
in a comparable population to determine the presence and functionality 
of residential smoke detectors, distribute home fire-safety literature, 
and recommend smoke detector installation, as needed, and (d) conduct 
evaluation of both groups 12 months post intervention implementation to 
assess the difference in effectiveness of intervention strategies. When 
requested, serve as a resource as issues arise relating to local 
ordinances requiring residential smoke detector use. If such ordinances 
exist promote their enforcement.
    4. Evaluate the effectiveness of local programs, including pre- and 
post-program estimates of the proportion of functional residential 
smoke detectors, as well as adequacy of residential smoke detector 
coverage among the target population. Coordinate evaluation of 
installation smoke detector promotion efforts in the target communities 
versus other strategies utilized in comparable communities to discern 
the effectiveness of each intervention.
    5. When requested, serve as a resource as issues arise relating to 
statewide legislation requiring residential smoke detector use. Promote 
enforcement if such legislation exists.
    6. Participate in a process of evaluation and improvement in which 
lessons learned are shared with other States implementing residential 
fire injury prevention programs.

C. Recipient Activities: Trauma Care System Development (Part IB)

    1. Provide a full-time coordinator with the authority, 
responsibility, and expertise to conduct and manage the state-level 
program.
    2. Plan, develop, and implement a data-driven system to monitor and 
evaluate prehospital and hospital compliance with TCS standards, 
utilizing such data sources as trauma registries, EMS run reports, 
hospital discharge data, vital statistics and autopsy records.
    3. Design, test, refine, and use methods to identify and respond to 
preventable trauma morbidity, complications, and disability among 
patients hospitalized from trauma throughout the TCS.
    4. Establish administrative rules and procedures for designating 
trauma centers, if needed.
    5. Administer and complete (if needed) a trauma center designation 
process.
    6. Establish or improve a TCS information system and collect and 
analyze TCS data.
    7. Develop a strategic plan to overcome specified barriers to an 
optimal TCS, and over time, monitor the impact of this strategic plan.
    8. Identify non-federal sources of support for the TCS.
    9. Participate in a process of evaluation and improvement in which 
lessons learned are shared with other States implementing trauma care 
systems.

D. Recipient Activities: Emergency Department Injury Surveillance (Part 
IC)

    1. Provide a full-time coordinator with the authority, 
responsibility, and expertise to conduct and manage the state-level 
program.
    2. Develop, implement, and evaluate a plan for conducting hospital 
ED surveillance.
    3. Conduct hospital emergency department surveillance, which 
includes (but is not limited to) the essential injury elements (see 
definitions) as specified in ``Data Elements for Emergency Department 
Systems'' (DEEDS), and collect information addressing demographics, 
diagnoses, treatment, etiology, severity, charges, and outcome.
    4. Evaluate the surveillance system for completeness and validity 
of data collected using methods described in ``Guidelines for 
Evaluating Surveillance Systems.''
    5. Develop and submit an annual report of the analysis of 
surveillance data, and compile and share aggregated data with CDC in 
electronic format.
    6. Participate in a process of evaluation and improvement in which 
lessons learned are shared with other States implementing ED 
surveillance.

E. Recipient Activities: Basic Injury Program Development (Part II)

    1. Provide a full-time coordinator who has the authority, 
responsibility, and expertise to conduct and manage the state-level 
program.
    2. Establish an advisory group to address issues relevant to injury 
prevention and control in the State. This group will consist of public 
and private individuals, organizations, agencies, and groups such as 
internal public health agency units (e.g., MCH, epidemiology, EMS, 
block grant coordination), Governor's Highway Safety Representatives, 
police, SAFE KIDS, NFPA Champions, National Safety Council, AARP, Brain 
Injury Association, trauma care organizations, violence prevention 
programs, and community-based organizations. The advisory group will 
advise and make recommendations in areas such as reviewing injury data, 
setting priorities,

[[Page 33882]]

assessing the public health agency's capacity and resources to address 
injury as a priority public health problem, and creating a State plan 
for injury prevention and control.
    3. Analyze existing data to define the magnitude of the injury 
problem in the State, the population(s) at risk, and the causes of 
injury. Potential data sources include E-coded hospital discharge data, 
vital statistics, emergency department data, BRFSS, fire incident 
reports, police records, child death review records, autopsy records, 
and EMS run reports.
    4. Prepare a report (for dissemination within the State) that 
includes an annotated inventory or data sources, the magnitude and 
causes of the injury problem in the State, and the populations 
affected.
    5. Identify and catalog current and potential injury prevention and 
control resources within the State.
    6. Develop a State plan which is based on data and prioritized for 
the prevention and control of injuries.
    7. Participate in a process of evaluation and improvement in which 
lessons learned are shared with other States implementing basic injury 
prevention programs.

F. CDC Activities

    1. Provide consultation on planning, implementation, evaluation, 
data analysis, and dissemination of results.
    2. Provide coordination between and among the States, by assisting 
in the transfer of information and methods developed to other programs, 
and providing up-to-date information.
    3. Provide technical assistance for program planning and 
management.
    4. Develop and provide BRFSS and other specific injury surveillance 
modules.
    5. Plan and coordinate review of program activities by outside 
experts to ensure available expertise and provide for quality 
assurance.
    6. Operate a process of evaluation and improvement in which lessons 
learned are shared with other States implementing the same type of 
program.

Technical Reporting Requirements

    An original and two copies of semiannual progress reports (and an 
electronic copy submitted by electronic mail to the project officer) 
are required of all awardees. Time lines for the reports will be 
established at the time of award. Final financial status and 
performance reports are required no later than 90 days after the end of 
the project period. All reports will be submitted to the Grants 
Management Branch, Procurement and Grants Office, CDC.
    Semiannual progress reports should include:
    A. A brief, updated program description, and a one-page summary of 
quarterly activities.
    B. A status report on accomplishment of program goals and 
objectives, accompanied by a comparison of the actual accomplishments 
related to the goals and objectives established for the period. Include 
target population, intervention/surveillance elements and activities, 
collaborative activities, and evaluation.
    C. If established goals and objectives were not accomplished or 
were delayed, describe both the reason for the deviation and 
anticipated corrective action or deletion of the activity from the 
project. Include lessons learned and recommendations.
    D. Other pertinent information, including changes in staffing, 
contractors, or partners.

Application Content

    A separate application should be submitted for each Part (topic 
area) for which funding is requested. Each application, including 
appendices, should not exceed 70 pages (75 pages for competing 
continuation applications) and the Proposal Narrative section should 
not exceed 30 pages. Competing continuation applications may add up to 
five pages (for a total of 35 pages) to address progress and outcomes 
from the prior funded program. Pages should be clearly numbered and a 
complete index to the application and any appendices included. The 
project narrative section must be double-spaced. The original and each 
copy of the application must be submitted unstapled and unbound. All 
materials must be typewritten, double-spaced, with unreduced type (font 
size 10 point or greater) on 8\1/2\'' by 11'' paper, with at least 1'' 
margins, headers and footers, and printed on one side only.
    The applicant should provide a detailed description of first-year 
activities and briefly describe future-year objectives and activities.

For Bicycle Helmet Promotion (Part IA1) Applications, the Application 
Must Include

A. Abstract
    A one page summary of the proposed program.
B. Progress Report: (To be completed by competing continuation 
applicants only.)
    Provide a detailed report on the achievements of the program over 
the preceding three-year period of CDC funding for prevention of 
bicycle-related head injuries. The applicant should include the 
accomplishments made with CDC funding covering all areas related to 
that cooperative agreement. The section should not exceed five pages.
C. Background and Capacity
    Identify suitable target populations and include data justifying 
need for the program regarding lack of helmet use in the target 
population and magnitude of the bicycle-related head injury problem. 
Justify the inclusion of high-risk, demographic, or other age groups 
beyond 5-12 years-old. Indicate ridership data by age and month or 
season if available. Provide supporting data. Demonstrate capacity to 
conduct the program. Include a description of current activities and 
previous experience in bicycle helmet promotion programs, including 
status of surveillance activities related to the program. Show the 
appropriateness of position descriptions, curriculum vitea's (CV's), 
and lines of command to accomplish program goals and objectives.
D. Goals and Objectives
    Include goals which are relevant to the purpose of the program and 
feasible for the project period. Goals should be specific and 
measurable. Include objectives which are feasible for the budget 
period, and which address all activities necessary to accomplish the 
purpose of the proposal. Objectives should be specific, time-framed, 
measurable, and realistic. If groups beyond 5-12 year-olds are 
targeted, include goals and objectives for them separately.
E. Methods and Staffing
    Describe activities at the State and local levels. Describe how the 
model bicycle helmet promotion program (see Where to Obtain Additional 
Information section) will be implemented, and why deviations from this 
model, if any, are necessary for the applicant's setting. Provide 
detail on proposed multifacetedness. Describe creative approaches to 
impact the high-risk (unhelmeted) target population. Provide: (a) A 
detailed description of proposed activities designed to achieve each 
objective and overall program goals, and which includes designation of 
responsibility for each action

[[Page 33883]]

undertaken; (b) a complete time frame indicating when each activity 
will occur; and (c) a description of the roles of each unit, 
organization, or agency, and coordination, supervision and degree of 
commitment (e.g., time, in-kind, financial) of staff, organizations, 
and agencies involved in activities. Show allocation of staff to the 
activities. Describe the roles and responsibilities of the project 
director and each staff member. Descriptions should include the 
position titles, education and experience required, and the percentage 
of time each will devote to the program. Curriculum vitae for existing 
staff should be included. Document specific concurrence of plans by all 
other involved parties, including consultants, and provide a letter 
from each consultant or outside agency describing their willingness and 
capacity to fulfill proposed responsibilities.
    For each local program conducting interventions, describe the local 
program's ability and commitment to: (a) Provide a coordinator who will 
act as liaison with the State, (b) organize a coalition of appropriate 
individuals, agencies, and organizations to generate community input 
and support for bicycle helmet promotion campaigns, (c) collaborate 
with the local health department, (d) state measurable objectives for 
the project, (e) conduct pre- and post-program observations of helmet 
use that collects data on at least 100 child bicyclists from 4 or more 
different types of sites (e.g., residential areas, bike paths, parks, 
to/from schools), (f) educate each child who receives a ``program'' 
helmet and the parents about proper use, fit, and maintenance and safe 
bicycle riding practices, (g) maintain records of helmet promotional 
activities and provide to the State coordinator at the requested 
interval.
    Women, Racial and Ethnic Minorities. Provide a description of the 
proposed plan for the inclusion of both sexes and racial and ethnic 
minority populations for appropriate representation.
F. Evaluation
    Provide sufficient detail on how the proposed evaluation system 
will document program process, effectiveness, and impact on helmet use. 
Evaluation should include progress in meeting program objectives. 
Demonstrate potential data sources for evaluation purposes, and 
document staff availability, expertise, experience, and capacity to 
perform the evaluation. Include a plan for reporting evaluation results 
and using evaluation information for programmatic decisions. Describe, 
if it exists, a capacity to monitor bicycle-related head injuries, 
costs associated with bicycle-related head injuries, and changes in 
health outcomes associated with the program. Describe the use of 
control populations to help differentiate program effects from 
background trends. Indicate willingness to participate in a process of 
continuous improvement which may require frequent review of progress 
and processes utilized, remediation of identified barriers, and 
adoption of modified methods and measures.
G. Collaboration
    Describe the relationships between the program and other 
organizations, agencies, and health department units (e.g. MCH) that 
relate to the program. Describe coalition membership and member roles. 
Describe relationships with the Governor's Office of Highway Safety, 
public safety officials, and Injury Control Research Centers (ICRC's) 
or local academic institutions, and show evidence of specific support. 
Describe relationships with local communities conducting intervention 
activities and show evidence of specific support. For areas with helmet 
laws, letters from appropriate officials should be provided that 
express a commitment to enforcement and detail the nature of their 
involvement and measures to be taken in the enforcement effort to 
promote helmet use.
H. Budget and Accompanying Justification
    Provide a detailed budget with accompanying narrative justifying 
all individual budget items which make up the total amount of funds 
requested. The budget should be consistent with stated objectives and 
planned activities. The budget should include funds for two trips to 
Atlanta by key State and community staff for participation in 
continuous improvement activities, and ``grantee'' meetings.
I. Human Subjects
    Indicate whether human subjects will be involved, and if so, how 
they will be protected, and describe the review process which will 
govern their participation.

For Residential Fire Injury Prevention (Part IA2), the Application Must 
Include

A. Abstract
    A one page abstract and summary of the proposed program.
B. Progress Report: (To be completed by competing continuation 
applicants only.)
    Provide a detailed report on the achievements of the program over 
the preceding three-year period of CDC funding for prevention of 
residential fire-related injuries. The applicant should include the 
accomplishments made with CDC funding covering all areas related to 
that cooperative agreement. The section should not exceed five pages.
C. Background, Need, and Capacity
    Describe background and need for the program, quantifying the 
magnitude of the residential fire-related injury problem (local versus 
State data), populations at risk, extent of the problem, and 
demographics of the targeted community. Include a description of 
current activities and previous experience in fire-related injury 
prevention programs (such as door-to-door campaigns), including status 
of surveillance activities related to the problem. Demonstrate capacity 
to conduct the program. Show the appropriateness of position 
descriptions, CV's, and lines of command to accomplish program goals 
and objectives.
D. Goals and Objectives
    Specify goals which indicate what the applicant anticipates its 
residential fire-related injury prevention program will have 
accomplished at the end of the three-year project period. Include 
specific time-framed, measurable and achievable objectives which can be 
accomplished during the first budget period. Objectives should relate 
directly to project goals, and should include, but not be limited to, 
increasing smoke detector usage and maintenance, and demonstrating the 
effectiveness of smoke detector intervention activities.
E. Methods and Staffing
    Describe how the model residential fire injury prevention program 
(see Where to Obtain Additional Information section) will be 
implemented and why deviations from this model, if any, are necessary 
for the applicant's setting. Specify how the target population 
corresponds to the high-risk population, as defined (see Background and 
Definitions section). Describe activities at the State and local levels 
that are designed to achieve each of the program objectives during the 
budget period. A time-frame should be included which indicates when 
each activity will occur. Include an organizational chart identifying 
placement of the residential fire-related injury prevention program. 
Show allocation of staff to the activities. Describe the roles and 
responsibilities of the project director and each staff member. 
Descriptions should include

[[Page 33884]]

the position titles, education and experience required, and the 
percentage of time each will devote to the program. CVs for existing 
staff should be included. Document specific concurrence of plans by all 
other involved parties, including consultants, and provide a letter 
from each consultant or outside agency describing their willingness and 
capacity to fulfill proposed responsibilities.
    For each local program conducting interventions, describe the 
program's ability and commitment to:
    1. Provide a coordinator to act as liaison with the State,
    2. Organize a coalition of appropriate individuals, agencies, and 
organizations to generate community input and support for smoke 
detector promotion campaigns,
    3. Collaborate with the local health department,
    4. State measurable objectives for the project,
    5. Conduct pre- and post-program household surveys of smoke 
detector use within the target and comparable populations,
    6. Educate residents who receive a home visit smoke detector on 
fire safety and smoke detector installation and maintenance,
    7. Maintain records of smoke detector promotional activities and 
provide to the state coordinator at the requested interval.
    Women, Racial and Ethnic Minorities. Provide a description of the 
proposed plan for the inclusion of both sexes and racial and ethnic 
minority populations for appropriate representation.
F. Evaluation
    Provide a detailed description of the methods and design to 
evaluate program effectiveness, including what will be evaluated, data 
to be used, and the time-frame. Document staff availability, expertise, 
and capacity to evaluate program activities and effectiveness, and 
demonstrate evaluation data availability. Evaluation should include 
progress in meeting the objectives and conducting activities on 
residential smoke detector programs (process evaluation measures), and 
increasing residential smoke detector prevalence and functionality 
(outcome measures). Describe the use of control populations to help 
differentiate program effects from background trends. Indicate 
willingness to participate in a process of continuous improvement which 
may require frequent review of progress and processes utilized, 
remediation of identified barriers, and adoption of modified methods 
and measures.
G. Coordination and Collaboration
    Provide a description of the relationship between the program and 
other organizations, agencies, and health department units that will 
relate to the program. Composition and roles of State and/or local 
coalitions should be included; specific commitments of support should 
be provided. Letters of support from public safety officials should 
also be included if related activities are undertaken. A description of 
proposed collaboration with ICRC's (see Where to Obtain Additional 
Information section) local academic institutions should be included.
H. Budget and Accompanying Justification
    Provide a detailed budget with accompanying narrative justifying 
all individual budget items which make up the total amount of funds 
requested. The budget should be consistent with stated objectives and 
planned activities. The budget should include funds for two trips to 
Atlanta by key State and community staff for participation in 
continuous improvement activities and ``grantee'' meetings.
I. Human Subjects
    Indicate whether human subjects will be involved, and if so, how 
they will be protected, and describe the review process which will 
govern their participation.

For Trauma Care System Development (Part IB), the Application Must 
Include

A. Abstract
    A one page summary of the proposed program.
B. Background and Capacity
    Define the current magnitude of trauma burden, in terms of 
mortality, hospitalizations, and/or disability. Define the current 
status of the trauma care system in the State, including the extent to 
which the key components of a TCS are currently in place (see Where to 
Obtain Additional Information section). Identify a sub-state target 
area (if such is proposed) and justify its need and use. Specify 
barriers to TCS planning, development, and operations. Demonstrate 
capacity to utilize data systems (e.g., trauma registries, hospital 
discharge data, autopsy records, EMS run reports, and surveys) that 
assess hospital trauma care capabilities. Demonstrate capacity to 
conduct the program. Show the appropriateness of position, 
descriptions, CV's, and lines of command to accomplishment of program 
goals and objectives.
C. Goals and Objectives
    Provide specific goals which indicate where the applicant 
anticipates its TCS program will be at the end of the three-year 
project period. Include specific time-framed, measurable, and 
achievable objectives that can be accomplished during the first budget 
period. Objectives should relate directly to the project goals, and 
should include, but not be limited to, improving the TCS structure and 
process and reducing trauma morbidity, mortality, and disability. 
Include objectives which address all activities necessary to accomplish 
the purpose of the proposal.
D. Methods and Staffing
    Describe how the model trauma care system (see Where to Obtain 
Additional Information section) will be implemented and why deviations 
from this model, if any, are necessary for the applicant's setting. 
Describe proposed activities at the State, regional, and local levels. 
Provide: (a) A detailed description of proposed activities which are 
designed to achieve each objective and overall program goals, and which 
includes designation of responsibility for each activity undertaken; 
(b) a complete time frame indicating when each activity will occur; and 
(c) a description of the roles of each unit, organization, or agency, 
and coordination, supervision, and degree of commitment (e.g., time, 
in-kind, financial) of staff, organizations, and agencies involved in 
activities. Show allocation of staff assigned to the activities. 
Describe the roles and responsibilities of the project director and 
each staff member. Descriptions should include the position titles, 
education and experience required, and the percentage of time each will 
devote to the program. CVs for existing staff should be included. 
Document specific concurrence of plans by all other involved parties, 
including consultants, and provide a letter from each consultant or 
outside agency describing their willingness and capacity to fulfill 
proposed responsibilities.
    Women, Racial and Ethnic Minorities. Provide a description of the 
proposed plan for the inclusion of both sexes and racial and ethnic 
minority populations for appropriate representation.
E. Evaluation
    Describe how the proposed evaluation system will document program 
progress, and how proposed evaluation measures will measure success in 
developing the TCS. Evaluation should include progress in meeting 
program objectives. Demonstrate potential data sources and

[[Page 33885]]

TCS information systems (or plans to develop one) for evaluation 
purposes, and document staff availability, expertise, experience, and 
capacity to perform the evaluation. Include a plan for reporting 
evaluation results and using evaluation information for programmatic 
decisions. Indicate willingness to participate in a process of 
continuous improvement which may require frequent review of progress 
and processes utilized, remediation of identified barriers, and 
adoption of modified methods and measures.
F. Coordination and Collaboration
    Provide a description of the relationship between the program and 
other organizations, agencies, and health department units that will 
associate with the program. Composition and roles of State, regional, 
and/or local coalitions should be included; specific commitments of 
support should be provided. A description of proposed collaboration 
with ICRC's (see Where to Obtain Additional Information section) or 
local academic institutions should be included.
G. Budget and Accompanying Justification
    Provide a detailed budget with accompanying narrative justifying 
all individual budget items which make up the total amount of funds 
requested. The budget should be consistent with stated objectives and 
planned activities. The budget should include funds for two trips to 
Atlanta by key State and community staff for participation in 
continuous quality improvement activities and ``grantee'' meetings.
H. Human Subjects
    Indicate whether human subjects will be involved, and if so, how 
they will be protected, and describe the review process which will 
govern their participation.

For Emergency Department Injury Surveillance (Part IC), the Application 
Must Include

A. Abstract
    A one page summary of the proposed program.
B. Background and Capacity
    Provide a brief description of the need for non-fatal injury 
surveillance within the State, and provide a description of the 
existing injury (fatal, hospitalized, and non-hospitalized) 
surveillance program within the jurisdiction, including:
    1. Existing staff and brief summary of their qualifications.
    2. Methods of current non-hospitalized injury surveillance, 
including: (a) Case definition(s), (b) Data elements collected, and (c) 
Data sources used and their completeness.
    3. A brief summary of any data analyses completed.
    4. A brief summary of any evaluations of surveillance system data 
quality which addresses the attributes of the surveillance system.
    Provide evidence of the existence of a statewide (or in a 
population of one million or more, which is representative of the 
State) population-based E-coded hospital discharge data system. Provide 
analysis of the most recent year of data from this system. Provide 
documentation that legislation and/or regulations are in place which 
support current collection of hospital emergency department data, and 
which protect the confidentiality of these data. Demonstrate capacity 
to conduct this injury surveillance program. Show the appropriateness 
of position descriptions, CV's, and lines of command to accomplish 
program goals and objectives. Provide a description of the capability 
for the entry, management, processing and analysis of data, including a 
description of available computer hardware and software resources.
C. Goals and Objectives
    Provide specific goals which indicate what the applicant 
anticipates its ED Injury Surveillance program will have accomplished 
at the end of the three-year project period. Include specific time-
framed, measurable, and achievable objectives that can be accomplished 
during the first budget period. Objectives should relate directly to 
the project goals. Include objectives which address all activities 
necessary to accomplish the purpose of the proposal.
D. Methods and Staffing
    Describe how the model ED surveillance program (see Where to Obtain 
Additional Information section) will be implemented and why deviations, 
if any, are necessary for the applicant's setting. Describe proposed 
activities at all involved levels (State, local, organization). 
Provide: (a) A detailed description of proposed activities which are 
designed to achieve each objective and overall program goals, and which 
includes designation of responsibility for each activity undertaken; 
(b) a complete time frame indicating when each activity will occur; and 
(c) a description of the roles of each unit, organization, or agency 
and coordination, supervision, and degree of commitment (e.g., time, 
in-kind, financial) of staff, organizations, and agencies involved in 
activities. Show allocation of staff to the activities. Describe the 
roles and responsibilities of the project director and each staff 
member. Descriptions should include the position titles, education and 
experience required, and the percentage of time each will devote to the 
program. CVs for existing staff should be included. Document specific 
concurrence of plans by all other involved parties, including 
consultants, and provide a letter from each consultant or outside 
agency describing their willingness and capacity to fulfill proposed 
responsibilities.
    Specifically, include proposed methods of system development or 
system enhancement, and data collection, including:
    1. Case definitions for inclusion in the system.
    2. A listing of data elements proposed for collection. Provide 
plans to incorporate the essential DEEDS data elements, as defined 
above. At a minimum, data elements collected for every case should 
include birthdate, age, sex, race, county (or zip code) of residence, 
ICD-9-CM diagnostic and external cause-of-injury codes, dates of 
encounter, or dates of injury and death (if applicable). Medical 
service charges should be included. If the plan includes use of a 
representative sample of hospital emergency department injury visits, 
provide the sampling frame and plan.
    3. All other sources of data that would be used to provide 
additional information on cases. Other optional sources of data might 
include hospital medical record, EMS, or police report data. Provide a 
brief description of the proposed use of data for injury prevention 
programs.
E. Evaluation
    Describe how the proposed evaluation activities will assess the 
sensitivity, predictive value positive, quality of the data collected, 
and other attributes of the surveillance system (e.g., 
representativeness, timeliness). Evaluation should include progress in 
meeting program objectives. Document staff availability, expertise, 
experience, and capacity to perform the evaluation. Include a plan for 
reporting evaluation results and using evaluation information for 
programmatic decisions. Indicate willingness to participate in a 
process of continuous improvement which may require frequent review of 
progress and processes utilized, remediation of identified barriers, 
and adoption of modified methods and measures.

[[Page 33886]]

F. Coordination and Collaboration
    Provide a description of the relationship between the program and 
other organizations, agencies, and health department units that will 
associate with the program. Composition and roles of State, regional, 
and/or local partners should be included; specific commitments of 
support should be provided. Include a description of proposed 
collaboration with ICRC's or local academic institutions.
G. Budget and Accompanying Justification
    Provide a detailed budget with accompanying narrative justifying 
all individual budget items which make up the total amount of funds 
requested. The budget should be consistent with stated objectives and 
planned activities. The budget should include funds for two trips to 
Atlanta by key State and community staff for participation in 
continuous improvement activities and ``grantee'' meetings.

For Basic Injury Prevention Programs (Part II), the Application Must 
Include

A. Abstract
    Provide a one page summary of the proposed program.
B. Background and Need
    Describe current and past injury control activities of the public 
health agency. Justify the need to develop a basic injury prevention 
and control program. Describe the benefit of creating or enhancing a 
State public health injury prevention and control focal point. Describe 
the type and nature of current and past advisory groups related to 
injury prevention and control. Demonstrate capacity to conduct the 
program.
C. Goals and Objectives
    Provide specific goals which indicate what the applicant 
anticipates its Basic Injury Prevention Program will have accomplished 
at the end of the three-year project period. Include specific time-
framed, measurable and achievable objectives that can be accomplished 
during the first budget period. Objectives should relate directly to 
the project goals. Include objectives which address all activities 
necessary to accomplish the purpose of the proposal. Specifically, they 
should include, but not be limited to, creation of an advisory 
structure, producing a profile of injuries in the State, assessing 
public health agency capacity to prevent injuries, and developing a 
State plan to address injury prevention and control.
D. Methods and Staffing
    Describe how the program will be implemented. Provide: (a) A 
detailed description of proposed activities designed to achieve each 
objective and overall program goals and which includes designation of 
responsibility for each activity undertaken; (b) a complete time frame 
indicating when each activity will occur; and (c) a description of the 
roles of each unit, organization, or agency and coordination, 
supervision, and degree of commitment (e.g., time, in-kind, financial) 
of staff, organizations, and agencies involved in activities. Show 
allocation of staff to the activities. Describe the roles and 
responsibilities of the project director and each staff member. 
Descriptions should include the position titles, education and 
experience required, and the percentage of time each will devote to the 
program. CVs for existing staff should be included. Document specific 
concurrence of plans by all other involved parties, including 
consultants, and provide a letter from each consultant or outside 
agency describing their willingness and capacity to fulfill proposed 
responsibilities.
E. Evaluation
    Describe how the proposed evaluation system will document program 
progress, and how proposed evaluation measures will measure success in 
developing basic injury prevention programs. Evaluation should include 
progress in meeting program objectives. Document staff availability, 
expertise, experience, and capacity to perform the evaluation. Include 
a plan for reporting evaluation results and using evaluation 
information for programmatic decisions. Indicate willingness to 
participate in a process of continuous improvement which may require 
frequent review of progress and processes utilized, remediation of 
identified barriers, and adoption of modified methods and measures.
F. Coordination and Collaboration
    Provide a description of the relationship between the program and 
other organizations, agencies, and health department units that will 
associate with the program. Composition and roles for the advisory 
structure and other partners should be included; specific commitments 
of support should be provided. Include a description of proposed 
collaboration with ICRC's (see Where to Obtain Additional Information 
section) or local academic institutions.
G. Budget and Accompanying Justification
    Provide a detailed budget with accompanying narrative justifying 
all individual budget items which make up the total amount of funds 
requested. The budget should be consistent with stated objectives and 
planned activities. The budget should include funds for two trips to 
Atlanta by key State staff for participation in continuous improvement 
activities and ``grantee'' meetings.

Evaluation Criteria

    Applications will be reviewed and evaluated according to the 
following criteria (maximum 100 total points):

A. Background, Need, and Capacity (30 percent)

    The extent to which the applicant presents data and information 
documenting the capacity to accomplish the program, positive progress 
in related past or current activities or programs, and, as appropriate, 
need for the program. The extent to which current resources demonstrate 
capability to conduct the program.

    Note: For competing continuation applicants, the extent to which 
past activities are presented completely and demonstrate attainment 
of objectives.

B. Goals and Objectives (10 percent)

    The extent to which the applicant includes goals which are relevant 
to the purpose of the proposal and feasible to accomplish during the 
project period, and the extent to which these are specific and 
measurable. The extent to which the applicant has included objectives 
which are feasible to accomplish during the budget period, and which 
address all activities necessary to accomplish the purpose of the 
proposal. The extent to which the objectives are specific, time-framed, 
measurable, and realistic.

C. Methods and Staffing (30 percent)

    The extent to which the applicant provides: (1) A detailed 
description of proposed activities which are likely to achieve each 
objective and overall program goals, and which includes designation of 
responsibility for each action undertaken; (2) a reasonable and 
complete schedule for implementing all activities; and (3) a 
description of the roles of each unit, organization, or agency, and 
evidence of coordination, supervision, and degree of commitment (e.g., 
time, in-kind, financial) of staff, organizations, and agencies 
involved in activities.
    The degree to which the applicant has met the CDC Policy 
requirements

[[Page 33887]]

regarding the inclusion of women, ethnic, and racial groups in the 
proposed project. This includes: (a) The proposed plan for the 
inclusion of both sexes and racial and ethnic minority populations for 
appropriate representation; (b) The proposed justification when 
representation is limited or absent; (c) A statement as to whether the 
design of the study is adequate to measure differences when warranted; 
and (d) A statement as to whether the plans for recruitment and 
outreach for study participants include the process of establishing 
partnerships with community(ies) and recognition of mutual benefits 
will be documented.

D. Evaluation (20 percent)

    The extent to which the proposed evaluation system is detailed, 
addresses goals and objectives of the program, and will document 
program process, effectiveness, and impact. The extent to which the 
applicant demonstrates potential data sources for evaluation purposes 
and methods to evaluate the data sources, and documents staff 
availability, expertise, experience, and capacity to perform the 
evaluation. The extent to which a feasible plan for reporting 
evaluation results and using evaluation information for programmatic 
decisions is included. The extent to which an agreement to participate 
in continuous improvement activities is present.

E. Collaboration (10 percent)

    The extent to which relationships between the program and other 
organizations, agencies, and health department units that will relate 
to the program or conduct related activities are clear, complete and 
provide for complementary or supplementary interactions. The extent to 
which coalition membership and roles are clear and appropriate. The 
extent to which relationships with ICRC'S or local academic 
institutions are completely described and activity-specific.

F. Budget and Justification (Not Weighted)

    The extent to which the applicant provides a detailed budget and 
narrative justification consistent with stated objectives and planned 
program activities.

G. Human Subjects (Applicable Parts Only) (Not Weighted)

    The extent to which the applicant describes the involvement of 
human subjects (if any) and the process which will govern their 
participation. The extent to which adequate safeguards are in place.

Executive Order 12372 Review

    Applications are subject to Intergovernmental Review of Federal 
Programs as governed by Executive Order (E.O.) 12372. 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 any necessary instructions on the 
State process. For proposed projects serving more than one State, the 
applicant is advised to contact the SPOC for each affected 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 send them to Ron S. 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 300, Mailstop E-13, Atlanta, GA 30305, no later than 30 days after 
the application deadline. (The appropriation for this financial 
assistance program was received late in the fiscal year and would not 
allow for the application receipt date which would accommodate the 60-
day recommendation process period.) The Program Announcement Number and 
Program Title should be referenced on the document. The granting agency 
does not guarantee to ``accommodate or explain'' the State process 
recommendations it receives after that date.

Public Health System Reporting Requirements

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

Catalog of Federal Domestic Assistance Number

    The Catalog of Federal Domestic Assistance number is 93.136.

Other Requirements

Paperwork Reduction Act

    Projects 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 (OMB) under the Paperwork 
Reduction Act.

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 to demonstrate that the project 
will be subject to initial and continuing review by an appropriate 
institutional review committee. The applicant will be responsible for 
providing assurance in accordance with the appropriate guidelines and 
forms provided in the application kit.

Women, Racial and Ethnic Minorities

    It is the policy of the Centers for Disease Control and Prevention 
(CDC) to ensure that individuals of both sexes and the various racial 
and ethnic groups will be included in CDC-supported research projects 
involving human subjects, whenever feasible and appropriate. Racial and 
ethnic groups are those defined in OMB Directive No. 15 and include 
American Indian, Alaskan Native, Asian, Pacific Islander, Black and 
Hispanic. Applicants shall ensure that women, racial and ethnic 
minority populations are appropriately represented in applications for 
research involving human subjects. Where a clear and compelling 
rationale exists that inclusion is inappropriate or not feasible, this 
situation must be explained as part of the application. This policy 
does not apply to research studies when the investigator cannot control 
the race, ethnicity, and/or sex of subjects. Further guidance to this 
policy is contained in the Federal Register, Vol. 60, No. 179, pages 
47949-47951, dated Friday, September 15, 1995.

Application Submission and Deadline

    The original and two copies of the application PHS Form 5161-1 
(Revised 7/92, OMB Number 0937-0189) must be submitted to Joanne A. 
Wojcik, Grants Management Specialist, 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 August 12, 1997.
    1. Deadline: Applications shall be considered as meeting 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 the U.S. Postal Service. Private 
metered postmarks will not be acceptable as proof of timely mailing.)

[[Page 33888]]

    2. Late Applications: Applications that 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 the applicant.

Where To Obtain Additional Information

    To receive additional written information call (404) 332-4561. You 
will be asked to leave your name, address, and telephone number and 
will need to reference Announcement 780. You will receive a complete 
program description, information on application procedures, and 
applications forms.
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from Joanne A. Wojcik, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Mailstop E-13, 
Atlanta, GA 30305, telephone (404) 842-6535 or Internet address 
<[email protected].
    Programmatic technical assistance may be obtained from:
    Part IA1: Bicycle Helmet Promotion Programs, Jeffrey Sacks, M.D., 
MPH, telephone (770) 488-4901, Mailstop K63, Internet address 
<[email protected]>.
    Part IA2: Residential Fire Injury Prevention Programs, Pauline 
Harvey, MSPH, telephone(770) 488-4592, Mailstop K63, Internet address 
<[email protected]>.
    Part IB: Trauma Care Systems Development, Paul Burlack, telephone 
(770) 488-4713, Mailstop F41, Internet address <[email protected]>.
    Part IC: Emergency Department Injury Surveillance, Daniel Sosin, 
M.D., MPH, telephone (770) 488-4233, Mailstop K02, Internet address 
<[email protected].
    Part II: Basic Injury Program Development, James Belloni, MA, 
telephone (770) 488-4538, Mailstop K02, Internet address 
<[email protected]>.
    National Center for Injury Prevention and Control, Centers for 
Disease Control and Prevention (CDC), 4770 Buford Highway, NE., 
Mailstop (Insert Mailstop from above), Atlanta, GA 30341-3724.
    The complete application kit includes a copy of the following 
listed addendums. These addendums provide the applicants with 
additional program guidance, such as additional background information 
and further define model programs described in this announcement and 
provide a complete listing of the ICRCs.

--Addendum IA1: Bicycle Helmet Promotion Programs
--Addendum IA2: Residential Fire Injury Prevention Programs
--Addendum IB: Trauma Care Systems Development
--Addendum IC: Emergency Department Injury Surveillance
--Addendum II: Injury Control Research Centers (ICRCs)

    This and other CDC announcements are available through the CDC 
homepage on the Internet. The address for the CDC homepage is <http://
www.cdc.gov>.
    CDC will not send application kits by facsimile or express mail.
    Please refer to Announcement 780 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: June 17, 1997.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 97-16310 Filed 6-20-97; 8:45 am]
BILLING CODE 4163-18-P