[Federal Register Volume 62, Number 137 (Thursday, July 17, 1997)]
[Notices]
[Pages 38308-38312]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-18819]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Announcement Number 787]


Research and Demonstration Programs in Surveillance, Prevention, 
and Control of Healthcare-Associated Infections and Antimicrobial 
Resistant Infections at Children's Hospitals

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of funds in fiscal year (FY) 1997 for a cooperative 
agreement program to develop research and demonstration programs in the 
surveillance, prevention, and control of healthcare-associated 
infections, antimicrobial resistant infections, and outcomes research 
at children's hospitals.
    CDC is committed to achieving the health promotion and disease 
prevention objectives of Healthy People 2000, a national activity to 
reduce morbidity and mortality and improve the quality of life. This 
announcement is related to the priority area of Immunization and 
Infectious Diseases. (For ordering a copy of Healthy People 2000, see 
the section Where To Obtain Additional Information.)

Authority

    This program is authorized under Sections 301(a), and 317(k)(2) of 
the Public Health Service Act, as amended [42 U.S.C. 241(a) and 
247b(k)(2)]. Applicable program regulations are found in 42 CFR Parts 
51b and 52, Grants for Preventive Health Service and Grants for 
Research Projects.

Smoke-Free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the nonuse of all tobacco products, and 
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in 
certain facilities that receive Federal funds in which education, 
library, day care, health care, and early childhood development 
services are provided to children.

Eligible Applicants

    Assistance will be provided only to public and private nonprofit 
organizations whose members include representatives of children's 
hospitals that have an interest in infection control, hospital 
epidemiology, antimicrobial use and resistance, and development and 
evaluation of benchmark or outcome measurements for patients at 
children's hospitals. These organizations must include members involved 
with hospitals, health systems, academic medical centers, and other 
entities which provide both hospital-based medical care and ambulatory 
care to a defined pediatric population.
    Applicants should demonstrate that they have a close relationship 
with a large number (N>40) of children's hospitals and that infection 
control personnel at these member hospitals are interested in 
participating in collaborative research studies to improve infection 
control programs in children's hospitals. Documentation of eligibility 
status including 501(c)(3) certification and listing of 10 or more 
relationships with children's hospitals must appear in the Abstract or 
Background and Need sections of Application Content.

    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 for the receipt of Federal funds constituting an award, 
grant

[[Page 38309]]

(cooperative agreement), contract, loan, or any other form.

Availability of Funds

    Approximately $200,000 will be available in FY 1997 to fund one 
award. It is expected that the award will begin on or about September 
30, 1997, for a 12-month budget period within a project period of up to 
3 years. Funding estimate may vary and is subject to change.
    Continuation awards within the project period will be made on the 
basis of satisfactory progress and the availability of funds. There are 
no matching or cost participation requirements; however, the 
applicant's anticipated contribution to the overall program costs, if 
any, should be provided on the application.

Use of Funds

Restrictions on Lobbying

    Applicants should be aware of restrictions on the use of Department 
of Health and Human Services (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 FY 1997 Departments of Labor, HHS, and Education, 
and Related Agencies 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. 
Section 503 of this new law, as enacted by the Omnibus Consolidated 
Appropriations Act, 1997, Division A, Title I, Section 101(e), Pub. L. 
No. 104-208 (September 30, 1996), 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.

Background

    Children's hospitals serve a unique population which have very 
special needs. The patient populations served by children's hospitals 
range in age from birth to adulthood and have a variety of underlying 
diseases which are very different from those seen in adult populations. 
Furthermore, the infectious diseases which this population acquire and 
the distribution of antimicrobials which they receive differ from that 
seen in adult populations. Thus, the infections control, infectious 
disease, and quality assurance needs of children's hospitals differ 
from those of general acute care facilities, whose patients are 
primarily adults.
    The epidemiology of nosocomial infections in children differ from 
adults in both the distribution of infections by site and by pathogen. 
Furthermore, the risk factors for nosocomial infection differ in 
children from adults because of the different types of exposures which 
children have which adults may not have. For instance, neonates in 
intensive care units frequently have umbilical artery or venous 
catheters but seldom have urinary catheters whereas adults often have 
urinary catheters and never have umbilical catheters. Despite the 
unique and special needs of children's hospital personnel, most 
infection control guideline recommendations, the national infection 
control surveillance system, recommendations for antimicrobial use, and 
quality of care benchmarks have either been developed in or written for 
general acute care facilities and their patient populations which are 
mostly adults.
    Because of the differences in the epidemiology of nosocomial 
infections, types of care given, infectious disease which occur, and 
antimicrobials which these patients receive, there is an urgent need 
for the establishment of a pediatric network so that children's 
hospital infection control and quality assurance personnel can develop 
children-specific infection surveillance and control programs, identify 
cost-effective infection control prevention interventions, design 
systems to improve antimicrobial use, and develop national benchmarking 
programs so that standards can be developed and used to assess the 
adequacy of infection control and patient care programs at children's 
hospitals.
    One of the major challenges to infectious disease and infection 
control personnel at children's hospitals is the increase in 
antimicrobial resistant pathogens and the increasing widespread use of 
antimicrobials. One of the patient populations with the greatest 
antimicrobial exposure is the pediatric age group, particularly infants 
and young children. In some reports, over 50 percent of the 
antimicrobials used in this population are inappropriate. Others have 
reported that 50 percent of infants and children with viral 
syndromes receive antimicrobials. Concomitant with this widespread use 
(and misuse) of antimicrobials have been increasing reports of the 
emergence of antimicrobial resistance in bacterial pathogens 
colonizing/infecting this population. In hospitalized children, 
methicillin-resistant Staphylococcus aureus (MRSA), penicillin-
resistant Streptococcus pneumoniae (PRP), and vancomycin-resistant 
enterococcus (VRE) colonizations/infections are increasing and 
nosocomial outbreaks have been reported. For all of these pathogens, 
antimicrobial use has been a risk factor for colonization/infection. 
Furthermore, the emergence of antimicrobial resistant pathogens in the 
hospitalized pediatric patient can lead to further transmission (and 
vice versa) in the community, particularly day care centers.
    Despite the fact that antimicrobial use is a risk factor for 
colonization/infection with resistant bacteria, virtually no studies 
have been conducted assessing the appropriateness of antimicrobial use 
in the pediatric inpatient setting. Such an assessment could lead to 
targeted intervention programs to reduce inappropriate antimicrobial 
use and reduce the pressure for emergence of antimicrobial pathogens in 
this population. Conduct of such projects in a group of children's 
hospitals will lesson the pressure to misuse such antimicrobials at any 
one institution and provide a program for all other children's 
hospitals to follow.
    Currently, there is no multicenter pediatric hospital study or 
surveillance system to monitor the use of antimicrobials, determine the 
prevalence of antimicrobial resistant pathogens, evaluate the risk 
factors for colonization/infection with these organisms, or develop, 
implement, or assess the efficacy of preventive interventions in 
reducing the emergence and transmission of these pathogens in pediatric 
settings. Although there has been a great interest in the pediatric 
infectious diseases, infection control,

[[Page 38310]]

and quality assurance community for such a network, sufficient 
financial support for such a project has been lacking and there has 
been the need for strong technical assistance from those with expertise 
in pediatric infectious diseases, infection control and quality 
assurance. A variety of pediatric infectious diseases groups have urged 
the Hospital Infections Program (HIP) of CDC to provide the technical 
support for the establishment of such a network. Such a network would 
be very beneficial to the children's hospital community, pediatric 
infectious diseases and infection control personnel and patients 
receiving care in these facilities.
    Such a network would have a major influence on pediatric infectious 
diseases, infection control, and quality assurance at all hospitals 
providing care for large numbers of pediatric patients. For the first 
time, through coordination of multiple children's hospitals, 
recommendations could be made to personnel at all facilities where 
pediatric patients receive care. These recommendations would include: 
(1) methods for surveillance, 2) clinical practices which improve 
patient care and reduce adverse outcomes, and (3) appropriate 
antimicrobial use. These national benchmark rates will permit accurate 
and reliable inter-and intra-hospital comparisons; also, those 
facilities which are outliers can evaluate differences in practices 
which may lead to elevated rates of adverse events. Such a network 
would have an enormous impact on improving pediatric patient care in 
the United States. Current pediatric organizations which are very 
interested in initiating such a network require the technical expertise 
of the HIP of CDC in surveillance, benchmark development, analytic 
epidemiology and antimicrobial use evaluation. Through partnership 
between the HIP and a group of children's hospitals, where the interest 
in developing specific standards and prevention interventions for 
pediatric patients exists, this cooperative agreement can have a major 
impact on reducing morbidity and mortality in children at these 
hospitals and in providing this community with pediatric-specific 
surveillance methods, antimicrobial use guidelines, benchmarks, and 
prevention interventions. This would be the first and only network 
established specifically for the benefit of children's hospitals and 
their special population.

Purpose

    The purpose of this cooperative agreement is to provide assistance 
in establishing a center for research and demonstration to improve the 
surveillance, prevention, and control of healthcare-associated 
infections and antimicrobial resistant infections in children's 
hospitals.

Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipients will be responsible for conducting activities under Item 
A., below, and CDC will be responsible for conducting activities under 
Item B., below:

A. Recipient Activities

    1. Establish a surveillance system for antimicrobial resistant 
pathogens at children's hospitals.
    2. Assess the relationship between antimicrobial use and the 
emergence of antimicrobial resistance, develop prevention 
interventions, and assess the efficacy of these interventions.
    3. Develop and administer educational programs to decrease misuse 
and improve the appropriateness of antimicrobial use by clinicians.
    4. Analyze and publish research findings.
    Activities listed below are optional:
    5. Assess the relationship between health care worker (i.e., 
nursing, physician, infection control, etc.) staffing levels and 
nosocomial infection risk.
    6. Conduct cost, cost efficacy and cost-benefit studies to identify 
the most useful infection control measures.
    7. Develop nosocomial infection outcome benchmark measurement 
methods to permit valid interhospital comparison of infection rates.
    8. Determine risk factors for nosocomial infection, develop 
prevention interventions, introduce the interventions, and assess their 
efficacy.
    9. Study the effectiveness of traditional hospital-based infection 
control methods and practice in integrated health care delivery 
systems.
    10. Develop and study innovative approaches to infection 
surveillance, prevention, and control that will maximize effectiveness.
    11. Develop and study improved evaluation methodologies to assess 
the effectiveness of prevention and control methods for healthcare-
associated infections and antimicrobial resistant infections.

B. CDC Activities

    1. Provide technical assistance in the design and conduct of 
research activities, in the design and implementation of innovative 
approaches to hospital epidemiologic and infection control practice and 
in the design of educational and training strategies and the 
dissemination of educational and training materials.
    2. Provide assistance to recipients regarding development of study 
protocols, data collection methods, and analyses as necessary.
    3. Assist in the development of data management processes and 
protocols.
    4. Assist in the analysis of research information and dissemination 
of research findings.

Technical Reporting Requirements

    An original and two copies of an annual performance report and 
financial status report are required no later than 90 days after the 
end of each budget period. A final performance report and financial 
status report are due no later than 90 days after the end of the 
project period. Please send all reports and other correspondence to: 
Sharron P. Orum, Grants Management Officer, Procurement and Grants 
Office, Centers for Disease Control and Prevention (CDC), 255 East 
Paces Ferry Road, NE., Mailstop E-18, Room 300, Atlanta, Georgia 30305.

Application Process

Intent Letter

    In order to assist CDC in planning for and executing the evaluation 
of applications submitted under this Program Announcement, all parties 
intending to submit an application are requested to inform CDC of their 
intention to do so at their earliest convenience prior to the 
application due date. Notification should include: (1) Name and address 
of institution and (2) name, address, and telephone number of contact 
person. Notification should be provided by facsimile, postal mail, or 
Email to Sharron Orum, Grants Management Officer, Procurement and 
Grants Office, Centers for Disease Control and Prevention (CDC), 255 
East Paces Ferry Road, NE., Mailstop E-18, Room 300, Atlanta, Georgia 
30305, facsimile (404) 842-6513.

Application Content

    All applicants must develop their applications in accordance with 
the PHS Form 5161-1 (OMB Number 0937-0189), information contained in 
this announcement, and the instructions outlined below.

General Instructions

    1. All pages must be clearly numbered.
    2. A complete index to the application and its appendixes must be 
included.
    3. The original and two copies of the application must be submitted 
unstapled and unbound. No bound materials will be accepted.

[[Page 38311]]

    4. All materials must be typewritten, single spaced, and in 
unreduced type (no smaller than font size 12) on 8\1/2\'' by 11'' white 
paper, with at least 1'' margins, headers, and footers.
    5. All pages must be printed on one side only.

Specific Instructions

    The application narrative must not exceed 10 pages (excluding 
budget and appendices). Unless indicated otherwise, all information 
requested below must appear in the narrative. Materials or information 
that should be part of the narrative will not be accepted if placed in 
the appendices. The application narrative must contain the following 
sections in the order presented below:
    1. Abstract: Provide a brief (two pages maximum) abstract of the 
project including documentation of eligibility status. State the length 
of the project period (maximum is 3 years) for which assistance is 
being requested (see the section Availability of Funds for additional 
information).
    2. Background and Need: Discuss the background and need for the 
proposed project. Demonstrate a clear understanding of the purpose and 
objectives of this cooperative agreement program. Illustrate and 
justify the need for the proposed project that is consistent with the 
purpose and objectives of this cooperative agreement program.
    3. Capacity and Personnel: Describe applicant's past experience in 
conducting projects/studies similar to that being proposed. Describe 
applicants resources, facilities, and professional personnel that will 
be involved in conducting the project. Include in an appendix 
curriculum vitae for all professional personnel involved with the 
project. Describe plans for administration of the project and identify 
administrative resources/personnel that will be assigned to the 
project. Provide in an appendix letters of support from all key 
participating non-applicant organizations, individuals, etc., which 
clearly indicate their commitment to participate as described in the 
operational plans. Do not include letters of support from CDC 
personnel. Letters of support from CDC will not be accepted in the 
application.
    4. Objectives and Technical Approach: Describe specific objectives 
for the proposed project which are measurable and time-phased and are 
consistent with the purpose and goals of this cooperative agreement. 
Present a detailed operational plan for initiating and conducting the 
project which clearly and appropriately addresses Recipient Activities 
(1-4) and any optional Activities (if proposing a multi-year project, 
provide a detailed description of first-year activities and a brief 
overview of activities in subsequent years. Clearly state the proposed 
length of the project period.) Clearly identify specific assigned 
responsibilities for all key professional personnel. Include a clear 
description of applicant's technical approach/methods which are 
directly relevant to the study objectives. Describe specific study 
protocols or plans for the development of study protocols. Describe the 
nature and extent of collaboration with CDC and/or others during 
various phases of the project. Describe in detail a plan for evaluating 
study results and for evaluating progress toward achieving project 
objectives.
    5. Budget: Provide in an appendix a budget and accompanying 
detailed justification for the first year of the project that is 
consistent with the purpose and objectives of this program. Also, 
provide estimated total budget for each subsequent year. If requesting 
funds for any contracts, provide the following information for each 
proposed contract: (a) Name of proposed contractor, (b) breakdown and 
justification for estimated costs, (c) description and scope of 
activities to be performed by contractor, (d) period of performance, 
and (e) method of contractor selection (e.g., sole-source or 
competitive solicitation).
    6. Human Subjects: Whether or not exempt from Department of Health 
and Human Services (DHHS) regulations, if the proposed project involves 
human subjects, describe in an appendix adequate procedures for the 
protection of human subjects. Also, ensure that women, racial and 
ethnic minority populations are appropriately represented in 
applications for research involving human beings.

Evaluation Criteria

    The applications will be reviewed and evaluated according to the 
following criteria: (Total 100 points)
    1. Background and Need (20 points): Extent to which applicant's 
discussion of the background for the proposed project demonstrates a 
clear understanding of the purpose and objectives of this cooperative 
agreement program. Extent to which applicant illustrates and justifies 
the need for the proposed project that is consistent with the purpose 
and objectives of this cooperative agreement program.
    2. Capacity (40 points total): a. Extent to which applicant 
describes adequate resources and facilities (both technical and 
administrative) for conducting the project. (10 points)
    b. Extent to which applicant documents that professional personnel 
involved in the project are qualified and have past experience and 
achievements in research related to that proposed as evidenced by 
curriculum vitae, publications, etc. (20 points)
    c. Extent to which applicant includes letters of support from non-
applicant organizations, individuals, etc. Extent to which the letters 
clearly indicate the author's commitment to participate as described in 
the operational plan. (10 points).
    3. Objectives and Technical Approach (40 points total): a. Extent 
to which applicant describes specific objectives of the proposed 
project which are consistent with the purpose and goals of this 
cooperative agreement program and which are measurable and time-phased. 
(10 points)
    b. Extent to which applicant presents a detailed operational plan 
for initiating and conducting the project, which clearly and 
appropriately addresses all Recipient Activities. Extent to which 
applicant clearly identifies specific assigned responsibilities for all 
key professional personnel. Extent to which the plan clearly describes 
applicant's technical approach/methods for conducting the proposed 
studies and extent to which the plan is adequate to accomplish the 
objectives. Extent to which applicant describes specific study 
protocols or plans for the development of study protocols that are 
appropriate for achieving project objectives. The degree to which the 
applicant has met the CDC policy requirements regarding the inclusion 
of women, ethnic, and racial groups in proposed research. This 
includes: (1) The proposed plan for the inclusion of both sexes and 
racial and ethnic minority populations for appropriate representation; 
(2) the proposed justification when representation is limited or 
absent; (3) a statement as to whether the design of the study is 
adequate to measure differences when warranted; and (4) documentation 
of plans for recruitment and outreach for study participants that 
includes the process of establishing partnerships with community(ies) 
and recognition of mutual benefits. (15 points)
    c. Extent to which applicant describes adequate and appropriate 
collaboration with CDC and/or others during various phases of the 
project. (10 points)
    d. Extent to which applicant provides a detailed and adequate plan 
for evaluating study results and for evaluating progress toward 
achieving project objectives. (5 points)

[[Page 38312]]

    4. Budget (not scored): Extent to which the proposed budget is 
reasonable, clearly justifiable, and consistent with the intended use 
of cooperative agreement funds.
    5. Human Subjects Research (not scored): If the proposed project 
involves human subjects, whether or not exempt from the DHHS 
regulations, the extent to which adequate procedures are described for 
the protection of human subjects. Note: Objective Review Group (ORG) 
recommendations on the adequacy of protections include: (a) protections 
appear adequate and there are no comments to make or concerns to raise, 
(b) protections appear adequate, but there are comments regarding the 
protocol, (c) protections appear inadequate and the ORG has concerns 
related to human subjects, (d) disapproval of the application is 
recommended because the research risks are sufficiently serious and 
protection against the risks are inadequate as to make the entire 
application unacceptable.

Executive Order 12372 Review

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

Public Health System Reporting Requirement

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

Catalog of Federal Domestic Assistance Number

    The Catalog of Federal Domestic Assistance Number is 93.283.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from ten 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 evidence of this assurance in accordance with the appropriate 
guidelines and form provided in the application kit.

Women, Racial and Ethnic Minorities

    It is the policy of the Centers for Disease Control and Prevention 
(CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR) 
to ensure that individuals of both sexes and the various racial and 
ethnic groups will be included in CDC/ATSDR-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 clear and compelling rationale 
exist 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 47947-
47951, dated Friday, September 15, 1995.

Application Submission and Deadline

    The original and two copies of the application Form PHS-5161-1 (OMB 
Number 0937-0189) must be submitted to Sharron P. Orum, Grants 
Management Officer, Grants Management Branch, Procurement and Grants 
Office, Centers for Disease Control and Prevention (CDC), 255 East 
Paces Ferry Road, NE., Mailstop E-18, Atlanta, Georgia 30305, on or 
before August 22, 1997.
    1. Deadline: Applications will be considered to meet the deadline 
if they are either:
    a. Received on or before the deadline date; or,
    b. Sent on or before the deadline date and received in time for 
submission to the independent 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 proof of timely mailing.)
    2. Late Applications: Applications which do not meet the criteria 
in 1.a. or 1.b. above, will be 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 refer to Announcement Number 787. You will receive a 
complete program description, information on application procedures, 
and application forms.
    If you have questions after reviewing the contents of all 
documents, business management technical assistance may be obtained 
from Locke Thompson, 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-18, Room 
300, Atlanta, Georgia 30305, telephone (404) 842-6595 or through the 
Internet or CDC WONDER electronic mail at: [email protected]. Programmatic 
technical assistance may be obtained from William R. Jarvis, M.D., 
Hospital Infections Program, National Center for Infectious Diseases, 
Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, 
Mailstop A-07, Atlanta, Georgia 30333, telephone (404) 639-6413.
    You may obtain this and other CDC announcements from one of two 
Internet sites on the actual publication date: CDC's homepage at http:/
/www.cdc.gov or at the Government Printing Office homepage (including 
free on-line access to the Federal Register at http://
www.access.gpo.gov).
    Please refer to Program Announcement Number 787 when requesting 
information and submitting an application on the Request for 
Assistance.
    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: July 11, 1997.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 97-18819 Filed 7-16-97; 8:45 am]
BILLING CODE 4163-18-P