[Federal Register Volume 63, Number 22 (Tuesday, February 3, 1998)]
[Notices]
[Pages 5548-5555]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2572]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Announcement 98018]


State and Local Childhood Lead Poisoning Prevention Program and 
State Childhood Blood Lead Surveillance Program; Notice of Availability 
of Funds for Fiscal Year 1998

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of funds in fiscal year (FY) 1998 for new and competing 
continuation State and local childhood lead poisoning prevention (CLPP) 
programs, and State childhood blood lead surveillance (CBLS) programs.
    The CDC is committed to achieving the health promotion and disease 
prevention objectives of ``Healthy People 2000'', a national activity 
to reduce morbidity and mortality and improve the quality of life. This 
announcement is related to the priority area of Environmental Health. 
(To order a copy of ``Healthy People 2000'', see the Where to Obtain 
Additional Information section.)

Authority

    This program is authorized under sections 301(a), 317A and 317B of 
the Public Health Service Act [42 U.S.C. 241(a), 247b-1, and 247b-3], 
as amended. Program regulations are set forth in Title 42, Code of 
Federal Regulations, Part 51b.

Smoke-Free Workplace

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

Eligible Applicants

    Eligible applicants for Part A: State and Local CLPP Programs
    Eligible applicants are State health departments or other state 
health agencies or departments deemed most appropriate by the state to 
direct and coordinate the State's childhood lead poisoning prevention 
program.
    Also eligible are agencies or units of local government that serve 
jurisdictional populations greater than 500,000. This eligibility 
includes health departments or other official organizational authority 
(agency or instrumentality) of the District of Columbia, the 
Commonwealth of Puerto Rico, any territory or possession of the United 
States, and all Indian tribes.
    Applicants for local CLPP program grants from eligible units of 
local jurisdictions must either apply directly to CDC or apply as part 
of a statewide grant application. Local jurisdictions cannot submit 
applications directly to CDC and also apply as part of a statewide 
grant application.

    Note: An organization described in section 501(c)(4) of the 
Internal Revenue Code of 1986 which engages in lobbying activities

[[Page 5549]]

shall not be eligible to receive Federal funds constituting an 
award, grant, loan, or any other form.

Eligible Applicants for Part B: CBLS Programs

    Eligible applicants are State health departments, the District of 
Columbia, the Commonwealth of Puerto Rico, any territory or possession 
of the United States, and all Indian tribes, or other State health 
agencies or departments deemed most appropriate by the state to direct 
and coordinate the state's CBLS program. Eligible applicants must have 
a requirement for reporting of blood lead levels (BLLs) by both public 
and private laboratories or provide assurances that such a requirement 
will be in place within 12 months of awarding the grant.

Eligible Applicants for Part C: Additional Funding for Assessment/
Evaluation Studies

    Eligible applicants for supplemental funds are all successful new 
and competing-continuation applicants for Part A and Part B, and also 
all non-competing continuation applicants for Part A and Part B.

Additional Information for All State Applicants

    If a State agency applying for grant funds is other than the 
official State health department, written concurrence by the State 
health department must be provided. State applicants may apply for 
funding from either Part A: CLPP Program or Part B: CBLS Program, but 
NOT both. State CLPP Program applicants should note that a CBLS 
component is a required part of a comprehensive State CLPP program and 
may be funded within the CLPP program grant.

Availability of Funds

Part A: State and Local CLPP Program

    Up to $11,000,000 will be available in FY 1998 to fund up to 15 new 
and competing continuation grants. CDC anticipates that awards for the 
first budget year will range from $75,000 to $1,500,000.
Awards for State applicants
    To determine the level of funding for which an individual State 
applicant for Part A is eligible, State applicants should refer to the 
accompanying table entitled ``State CLPPs Only: Funding Categories 
Based on Projected Level of Effort Required to Provide Prevention 
Services to a State Population.''
    Awards for eligible counties and cities, territories, tribes and 
the District of Columbia will range from $250,000-$450,000, with an 
average award of $350,000.

Funding for Part B: State CBLS Programs

    Up to $700,000 will be available in FY 1998 to fund up to 8 new and 
competing-continuation grants to support the development of CBLS 
programs. CBLS awards are expected to range from $75,000 to $95,000, 
with the average award being approximately $85,000. Funds must be used 
to initiate and build capacity for CBLS. Therefore, any applicant that 
already has in place a CBLS activity must demonstrate how these grant 
funds will be used to enhance, expand, or improve the current activity 
in order to remain eligible for funding. CDC funds should be added to 
CBLS funding from other sources, if such funding exists. Funds for 
these programs may not be used in place of any existing funding for 
CBLS.

Funding for Part C: Additional Funds for Assessment/Evaluation Studies

    Approximately $150,000 in additional/supplemental funds will be 
available in FY 1998 to fund up to 3 assessment/evaluation studies. 
Funds will be awarded for assessment/evaluation studies that address 
one of the following:
    1. Assessment of lead exposure in a jurisdictional population or 
subpopulation, using an approach to surveillance that differs from the 
complete statewide CBLS system described in this announcement.
    2. Evaluation of the impact of lead screening recommendations on 
screening for high-risk children.
    3. Evaluation of an approach to primary prevention in a high-risk 
area.

Additional Information on Funding

    For State applicants for Part A: CLPP funding only: Determine your 
funding category (Category 1, 2, or 3) according to the table on the 
next page. The range and average of awards for each funding category as 
follows:

Category 1: $800,000-$1,500,000, average award $1,000,000
Category 2: $250,000-$800,000, average award $520,000
Category 3: $75,000-$250,000, average award $150,000

State CLPPPs Only: Funding Categories Based on Projected Level of Effort
      Required to Provide Prevention Services to a State Population     
------------------------------------------------------------------------
                                                                        
------------------------------------------------------------------------
Alabama........................................................        2
Alaska.........................................................        3
Arizona........................................................        3
Arkansas.......................................................        2
California*....................................................        1
Colorado.......................................................        3
Connecticut....................................................        2
Delaware.......................................................        3
Florida*.......................................................        3
Georgia........................................................        2
Hawaii.........................................................        3
Idaho..........................................................        3
Illinois.......................................................        1
Indiana*.......................................................        3
Iowa...........................................................        2
Kansas.........................................................        2
Kentucky*......................................................        3
Louisiana......................................................        2
Maine..........................................................        3
Maryland.......................................................        2
Mass...........................................................        2
Michigan*......................................................        2
Minnesota......................................................        2
Mississippi....................................................        2
Missouri.......................................................        2
Montana........................................................        3
Nebraska.......................................................        2
Nevada.........................................................        3
N. Hampshire...................................................        3
New Jersey.....................................................        2
New Mexico.....................................................        3
New York*......................................................        2
N. Carolina....................................................        2
North Dakota...................................................        3
Ohio...........................................................        1
Oklahoma.......................................................        2
Oregon.........................................................        3
Pennsylvania...................................................        1
Rhode Island...................................................        2
S. Carolina....................................................        2
South Dakota...................................................        2
Tennessee......................................................        2
Texas*.........................................................        1
Utah...........................................................        3
Vermont........................................................        3
Virginia.......................................................        2
Washington.....................................................        2
West Virginia..................................................        2
Wisconsin......................................................        2
Wyoming........................................................        3
------------------------------------------------------------------------
* Projected level of effort adjusted to account for currently funded    
  locales.                                                              

    Each applicant must use the funding category that is specified for 
the applicant's State. CDC will not consider any State application that 
contains a funding request, including both direct and indirect costs, 
in excess of the funding limit given for the applicant's State. Any 
such application will be returned as non-responsive to the program 
announcement. However, an applicant may request an amount that is less 
than the lower limit of the range given for the applicant's 
jurisdiction.

[[Page 5550]]

Additional Information on Funding for All Applicants for Part A and 
Part B

    New awards are expected to begin on or about July 1, 1998, and are 
made for 12-month budget periods within project periods not to exceed 3 
years. Estimates outlined above are subject to change based on the 
actual availability of funds and the scope and quality of applications 
received. Continuation awards within the project period will be made on 
the basis of satisfactory progress and availability of funds. Grant 
awards cannot supplant existing funding for CLPP or CBLS programs. 
Grant funds should be used to increase the level of expenditures from 
State, local, and other funding sources. Awards will be made with the 
expectation that program activities will continue when grant funds are 
terminated.

Additional Information on Funding for All Applicants for Part C.

    Additional/supplemental funds are to begin on or about July 1, 
1998, and are made for a 12-month budget period in a project period not 
to exceed the time period of the main grant.

Note:
     Grant funds may not be expended for medical care and 
treatment or for environmental remediation of source of lead 
exposure. However, the applicant must provide a plan to ensure that 
these program activities are carried out.
     Not more than 10 percent (exclusive of Direct 
Assistance) of any grant may be obligated for administrative costs. 
This 10 percent limitation is in lieu of, and replaces, the indirect 
cost rate.

Use of Funds--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. 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 1998 HHS Appropriations Act expressly prohibits 
the use of 1998 appropriated funds for indirect or ``grass roots'' 
lobbying efforts that are designed to support or defeat legislation 
pending before State legislatures. Section 503 of Public Law 105-78, 
provides as follows:
    (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, or any State 
legislature, 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 and Definitions

Background

    In the last few years, there have been three major changes in the 
context within which CLPP and CBLS programs function. These are:
     Changing functions of health departments. Many health 
departments have ceased to be major providers of direct screening and 
follow-up care services, as Medicaid beneficiaries who formerly 
received preventive health care in health departments have enrolled in 
managed-care organizations. A decrease in funding has occurred in many 
health departments.
     Renewed emphasis on accountability of government agencies. 
A renewed call for accountability in government agencies requires that 
health departments document both the need for and the impact of their 
programs.
     Continuing declines in BLLs of the entire U.S. population, 
resulting in wide variation among jurisdictions with regard to the 
magnitude of their childhood lead poisoning problems.
    Resource limitations and the demand for public accountability have 
made it increasingly important for health departments to perform the 
core functions of public health as outlined in The Future of Public 
Health (IOM, 1988). These core functions are assessment, policy 
development, and assurance. Health department personnel must also 
accomplish their missions through others, by deepening relationships 
among new and old partners both in and outside of the health 
department. Also, the widening disparity among jurisdictions with 
regard to the magnitude of the childhood lead poisoning problem has 
focused attention on state and local health departments, as opposed to 
the Federal government, as the appropriate decision-makers for lead 
screening. Taken together, these changes are having a profound impact 
on CLPP programs, necessitating a change in programmatic emphasis.
    CLPP and CBLS programs are positioned to bring about improved 
screening and follow-up care for children with elevated BLLs, improved 
public and professional awareness of the problem of childhood lead 
poisoning, and improved childhood blood lead surveillance, by 
performing the three core public health functions related to childhood 
lead poisoning prevention.

Definitions

     Assessment: Activities organized by a health department 
for the purpose of determining the risk for lead exposure among the 
children in its jurisdiction and the adequacy of programmatic 
activities to address this risk.
     Assurance: Activities organized by a health department for 
the purpose of (1) monitoring the provision of CLPP services including 
screening, follow-up care, and public and professional education; and 
(2) ensuring, as a provider of last resort, the availability of 
necessary services.
     Care coordination: The monitoring and organizing of 
follow-up care for a child with an elevated blood lead level (BLL). 
Follow-up care includes both medical and environmental interventions.
     High-risk: A term used to designate areas, populations, 
and individuals with risk for lead exposure that is assessed or 
demonstrated to be higher than average.
     Lead hazard: Accessible paint, dust, soil, water, or other 
source or pathway that contains lead or lead compounds that can 
contribute to or cause elevated BLLs.
     Lead hazard remediation: The elimination, reduction, or 
containment of known and accessible lead sources.
     Policy development: Activities organized by a health 
department for the purpose of framing the CLPP problem and establishing 
the response to it in its jurisdictions; includes development, 
oversight, and evaluation of necessary programs, relationships, and 
policies that will support CLPP.
     Primary prevention: The prevention of elevated BLLs in an 
individual or population, usually by reducing or eliminating lead 
hazards in the environment.

[[Page 5551]]

     Program: A designated unit within an agency responsible 
for implementing and coordinating a systematic and comprehensive 
approach to CLPP and CBLS.
     Surveillance: A process which (1) systematically collects 
information over time about children with elevated BLLs using 
laboratory reports as the data source; (2) provides for the follow-up 
of cases, including field investigations when necessary; (3) provides 
timely and useful analysis and reporting of the accumulated data, 
including an estimate of the rate of elevated BLLs among all children 
receiving blood tests; and (4) reports data to CDC in the appropriate 
format.

Purpose

    The purpose of this grant program is to bring about: (1) Screening 
for children who are potentially exposed to lead, and follow-up care 
for children who are identified with elevated BLLs; (2) awareness and 
action among the general public and concerned professionals in relation 
to preventing childhood lead poisoning; and (3) collaboration with 
other government and community-based organizations for primary 
prevention of lead poisoning in high-risk areas. To achieve this 
purpose, grant recipients are expected to improve their capacity to 
perform core public health functions related to CLPP and, for all state 
grant recipients, to develop statewide capacity for conducting CBLS.
    These awards should assist State and local health departments in 
balancing core public health functions. In some places, achieving this 
balance will mean shifting emphasis away from provision of direct 
screening and follow-up services and toward improvement of coalitions 
and partnerships; providing better and more sophisticated assessment; 
and developing and evaluating policies and programs in a manner that is 
firmly grounded in improved assessment. In other places where this 
balance already exists, the award should help enhance existing 
activities.

Program Requirements

Part A: State and Local CLPP Programs

    The following are requirements for CLPP Programs:
    1. A director/coordinator with authority and responsibility to 
carry out the requirements of the program.
    2. Provide qualified staff, other resources, and knowledge to 
implement the provisions of the program. Applicants requesting grant 
supported positions must provide assurances that such positions will be 
approved by the applicant's personnel system.
    3. For State applicants, commitment to develop a statewide 
childhood blood lead surveillance (CBLS) system in accordance with CDC 
guidance and to submit surveillance data annually to CDC. For local 
applicants, commitment to develop a data management system that is part 
of a state CBLS, where applicable; otherwise, local applicants must 
develop an automated data management system to collect and maintain 
data on the results of blood lead testing and data on follow-up care 
for children with elevated BLLs. For both State and local applicants, 
commitment to use these systems to monitor adequacy of screening of 
high-risk children and of follow-up care for children with elevated 
BLLs.
    4. For State applicants, commitment to development a statewide 
childhood blood lead screening plan consistent with CDC guidance 
provided in Screening Young Children for Lead Poisoning: Guidance for 
State and Local Public Health Officials. For local applicants, 
commitment to participate in the statewide planning process.
    5. Establish effective, well-defined working relationships within 
public health agencies and with other agencies and organizations at 
national, State, and community levels (e.g., housing authorities; 
environmental agencies; maternal and child health programs; State 
Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) 
programs; community and migrant health centers; community-based 
organizations providing health and social services in or near public 
housing units, as authorized under Section 340A of the PHS Act; State 
epidemiology programs; State and local housing rehabilitation programs; 
schools of public health and medical schools; and environmental 
interest groups).
    6. Assurances that income earned by the CLPP program is returned to 
the program for its use.
    7. Program maintains a system to monitor the notification and 
follow-up of children who are confirmed with elevated BLLs and who are 
referred to local Public Housing Authorities.
    8. For State CLPP Programs provide managerial, technical, 
analytical, and program evaluation assistance to local agencies in 
developing or strengthening CLPP programs.
    9. SPECIAL REQUIREMENT regarding Medicaid provider-status of 
applicants: Pursuant to section 317A of the Public Health Service Act 
(42 U.S.C. 247b-1), as amended by Section 303 of the ``Preventive 
Health Amendments of 1992'' (Pub. L. 102-531), applicants AND current 
grantees must meet the following requirements: For CLPP program 
services which are Medicaid-reimbursable in the applicant's State:
     Applicants who directly provide these services must be 
enrolled with their State Medicaid agency as Medicaid providers.
     Providers who enter into agreements with the applicant to 
provide such services must be enrolled with their State Medicaid agency 
as providers. An exception to this requirement will be made for 
providers whose services are provided free of charge and who accept no 
reimbursement from any third-party payer. Such providers who accept 
voluntary donations may still be exempted from this requirement.

Part B: CBLS Programs

    The following are requirements for CBLS Programs:
    1. A full-time director/coordinator with authority and 
responsibility to carry out the requirements of surveillance program 
activities.
    2. Provide qualified staff, other resources, and knowledge to 
implement the provisions of this program. Applicants requesting grant-
supported positions must provide assurances that such positions will be 
approved by the applicant's personnel system.
    3. Establish effective, well-defined working relationships with 
CLPP programs within the applicant's State.
    4. Revise, refine, and carrying out, in collaboration with CDC, the 
proposed methodology for conducting CBLS.
    5. Evaluate any interim and/or final evaluation of the CBLS 
activity in collaboration with CDC.
    6. Commitment to development a statewide childhood blood lead 
screening plan consistent with CDC guidance provided in Screening Young 
Children for Lead Poisoning: Guidance for State and Local Public Health 
Officials.
    7. Monitoring and evaluation of all major program activities and 
services.
    8. Conduct and evaluate public health programs or having access to 
professionals who are knowledgeable in conducting such activities.
    9. Translate data to State and local public health officials, 
policy- and decision-makers, and others seeking to strengthen program 
efforts.
    10. Report CBLS data to CDC in the approved OMB format.

Part C: Assessment/Evaluation Studies

    The following are requirements for Assessment/Evaluation Studies:
    1. A study director with specific authority and responsibility to 
carry out the requirements of the project.

[[Page 5552]]

    2. Demonstrated ability to collect and analyze data necessary for 
the conduct of the assessment/evaluation study. (OMB Number 0920-0337)
    3. Conduct administrative arrangements required by the study.
    4. Staff with demonstrated experience in conducting relevant 
epidemiologic studies, including publication of original research in 
peer-reviewed journals.
    5. Establish effective and well-defined working relationships 
within the performing organization and with outside entities which will 
ensure implementation of the proposed study.

Technical Reporting Requirements

    Quarterly progress reports (OMB Number 0920-0282) are required of 
all grantees. The quarterly report should not exceed 25 pages. Time 
lines for the quarterly reports will be established at the time of 
award, but are typically due 30 days after the end of each quarter. 
Note that CBLS-only grantees are not required to submit quarterly 
quantitative data.
    Annual Financial Status Reports (FSRs) are due 90 days after the 
end of the budget period. The final progress report and FSR shall be 
prepared and submitted no later than 90 days after the end of the 
project period. Submit the original and two copies of the reports to 
the Grants Management Office indicated in ``Where to Obtain Additional 
Information''.

Application Contents

    Please refer to the Program Guidance included with the application 
package for important information about completing your application.
     Applications for CLPP and CBLS Programs must be developed 
in accordance with PHS Form 5161-1, and should follow the structure 
presented in the Program Guidance document provided by CDC.
     Applications for additional funds for assessment/
evaluation studies must be developed in accordance with PHS Form 398.
     Application pages must be clearly numbered, and a complete 
index to the application and its appendices must be included.
     The original and two copies of the application set must be 
submitted UNSTAPLED and UNBOUND. All material must be typewritten, 
double spaced, printed on one side only, with un-reduced type on 8\1/
2\'' by 11'' paper, and at least 1'' margins and heading and footers. 
All graphics, maps, overlays, etc., should be in black and white and 
meet the above criteria.
     The main body of CLPP and CBLS Program applications should 
not exceed 75 pages. Supplemental information may be placed in 
appendices and should not exceed 25 pages. Competing continuation 
applicants should submit a progress report no longer than 10 pages.
     The main body of applications for additional funds for 
assessment/evaluation studies should not exceed the page limit set in 
``Part C'' of the program guidance document.

Evaluation Criteria

    The review of applications will be conducted by an objective review 
committee who will review the quality of the application based on the 
strength and completeness of the plan submitted. The budget 
justification will be used to assess how well the technical plan is 
likely to be carried out using available resources. For state CLPP 
Programs, funding requests must be consistent with each applicant's 
funding category or adjusted funding category. (See section entitled 
``Availability of Funds'' for detailed guidance.) The maximum rating 
score of an application is 100 points.

Part A: State and Local CLPP Program--Factors To Be considered

------------------------------------------------------------------------
                     Evaluation criterion                        Points 
------------------------------------------------------------------------
1. Problem statement and evidence of need.....................        15
2. Surveillance activities....................................        16
    State: Development of CBLS                                          
    Local: Automated data--management and tracking system               
3. Collaboration and statewide planning.......................        15
4. Core public health functions...............................        25
5. Goals and objectives.......................................        15
6. Program management and staffing............................        14
7. Budget and justificationnot scored.........................     (\1\)
                                                               ---------
    Total Maximum Points......................................       100
------------------------------------------------------------------------
\1\ Not scored.                                                         

Part A: State and Local CLPP Programs--Factors To Be Considered

    1. Problem statement and evidence of need (15 Points)
    a. The applicant's description and understanding of the burden and 
distribution of childhood lead exposure or elevated BLLs in the 
jurisdiction, using evidence (as available) of incidence and/or 
prevalence and demographic indicators. (10 points)
    b. The applicant's description of and the extent of current 
prevention activities, including need, available resources, gaps, and 
use of this award to address gaps. (5 points)
    2. Surveillance activities (16 points)
    The clarity, feasibility, and scientific soundness of the 
surveillance approach. Also, the extent to which a proposed schedule 
for accomplishing each activity and methods for evaluating each 
activity are clearly defined and appropriate.
    For State applicants, the following elements will be specifically 
evaluated:
    a. How laboratories are identified and data will be transmitted. (2 
points)
    b. How data will be collected and managed. (2 points)
    c. How quality of data and timeliness and completeness of reporting 
will be ensured. (2 points)
    d. How data will be used by program. (2 points)
    e. How summary data will be reported and disseminated. (2 points)
    f. How and when data will be analyzed. (2 points)
    g. Provisions to obtain denominator data (results of all laboratory 
blood lead tests, regardless of level). (2 points)
    h. Time line and methods for evaluating CBLS approach. (2 points)
    For local applicants, the following elements will be specifically 
evaluated:
    a. How laboratory reports will be received and data transmitted. (2 
points)
    b. How data will be collected and managed. (2 points)
    c. How quality of data and timeliness and completeness of reporting 
will be assured. (2 points)
    d. How data will be analyzed and used by the program. (2 points)

[[Page 5553]]

    e. How summary data will be reported and disseminated. (2 points)
    f. Coordination with state systems. (2 points)
    g. Provisions to obtain denominator data (results of all laboratory 
blood lead tests, regardless of level). (2 points)
    h. Time line and methods for evaluating data-collection approach. 
(2 points)
    3. Collaboration and statewide planning (15 Points)
    a. Evidence of collaboration with principal partners, including 
managed-care organizations, state Medicaid agency, child health-care 
providers and provider groups, insurers, community-based organizations, 
housing agencies, and banking, real-estate, and property-owner 
interests, as demonstrated by letters of support, memoranda of 
understanding, contracts, or other documented evidence of relationships 
with important collaborators. (5 points)
    b. The approach to developing and carrying out an inclusive State- 
or jurisdiction-wide screening plan as outlined in Screening Young 
Children for Lead Poisoning: Guidance for State and Local Health 
Officials. (5 points)
    c. Description of how collaborations are expected to result in 
improved prevention. (5 points)
    4. Capacity to carry out public-health core functions (25 Points)
    a. The description of the approach and activities necessary to 
achieve a balance among health department roles in CLPP, including 
assessment, program and policy development, and monitoring, evaluation, 
and ensuring provision of all necessary components of comprehensive 
CLPP. (5 points)
    b. The epidemiologic capacity and structure in place or planned to 
provide on-going analysis of: (1) population-based data and (2) program 
activities described in the application. (5 points)
    c. The health education and health communication capacity in place 
or planned to reach out to actual and potential collaborators and 
partners to achieve program goals. (5 points)
    d. The capacity in place or planned to fill in the gaps in direct 
service provision, where gaps have been demonstrated. (5 points)
    e. The evaluation capacity in place or planned to examine basic 
data on CLPP burden and program activities and make course corrections. 
(5 points)
    5. Goals and objectives (15 Points)
    Evaluation will be based on the quality of goals and objectives 
related to the Program Activities listed in the accompanying Program 
Guidance. For state applicants, evaluation will assess the soundness of 
goals and objectives to bring about all eight elements of a statewide 
childhood blood lead surveillance system. Objectives must be relevant, 
specific, measurable, achievable, and time-framed. There must be a 
formal work plan with a description of methods and a timetable for 
accomplishment of each objective.
    6. Project management and staffing (14 Points)
    a. A description of proposed staffing for health department roles 
in CLPP, including the plan to expedite filling of all positions and 
written assurances that requested positions have been or will be 
approved by applicant's personnel system. (5 points)
    b. A description of the responsibilities of individual health 
department staff members, including the level of effort and time. (5 
points)
    c. The plan to provide training to health department personnel and 
technical assistance to collaborators outside the health department, 
including proposed design of information-sharing systems. (4 points)
    7. Budget justification (not scored).
    Evaluation will be based on the extent to which the budget is 
reasonable, clearly justified, and consistent with the intended use of 
funds.

Part B: CBLS Programs--Factors To Be Considered

------------------------------------------------------------------------
                     Evaluation criterion                        Points 
------------------------------------------------------------------------
1. Problem statement and evidence of need.....................        10
2. Surveillance activities....................................        30
3. Use of existing resources..................................        10
4. Collaboration and statewide planning.......................        10
5. Progress toward CBLS.......................................        20
6. Project sustainability.....................................        10
7. Personnel..................................................        10
8. Budget and justification...................................     (\1\)
                                                               ---------
    Total Maximum Points......................................      100 
------------------------------------------------------------------------
\1\ Not scored.                                                         

Part B: CBLS Programs--Factors To Be Considered

    1. Problem statement and evidence of need (10 Points)
    a. The applicant's description and understanding of the burden and 
distribution of childhood lead exposure or elevated BLLs in the 
jurisdiction, using evidence (as available) of incidence and/or 
prevalence and demographic indicators. (5 points)
    b. The applicant's description of and the extent of current 
prevention activities, including need, available resources, gaps, and 
use of this award to address gaps. (5 points)
    2. Surveillance activities (30 Points)
    The clarity, feasibility, and scientific soundness of the 
surveillance approach. Also, the extent to which a proposed schedule 
for accomplishing each activity and methods for evaluating each 
activity are clearly defined and appropriate. The following points will 
be specifically evaluated:
    a. How laboratories are identified and data will be transmitted. (3 
points)
    b. How data will be collected and managed. (3 points)
    c. How quality of data and timeliness and completeness of reporting 
will be ensured. (3 points)
    d. How data will be used by program. (3 points)
    e. How summary data will be reported and disseminated. (3 points)
    f. How and when data will be analyzed. (3 points)
    g. Provisions to obtain denominator data (results of all laboratory 
blood lead tests, regardless of level). (3 points)
    h. Time line and methods for evaluating CBLS approach. (3 points)
    i. Protocols for follow-up of individuals with elevated BLLs. (3 
points)
    j. Ability of the system to provide data to estimate the burden of 
lead exposure in the state and conduct special studies. (3 points)
    3. Use of existing resources (10 Points)
    The extent to which the proposal would make effective use of 
existing resources and expertise within the applicant agency or through 
collaboration with other agencies.
    4. Collaboration and statewide planning (10 Points)
    The approach to developing and carrying out an inclusive statewide 
screening plan as outlined in Screening Young Children for Lead 
Poisoning: Guidance for State and Local Health Officials.
    5. Progress toward complete blood-lead surveillance (20 Points)
    a. The extent to which the proposed activities are likely to result 
in substantial progress toward establishing a complete statewide 
childhood blood lead surveillance activity. (15 points)
    b. A description of how data will be used to measure impact of 
public policy decisions. (5 points)
    6. Project sustainability (10 Points)
    The extent to which the proposed activities are likely to result in 
the long-term maintenance of a complete statewide CBLS system. In 
particular, specific activities that will be undertaken by the state 
during the project period to ensure that the surveillance program 
continues after completion of the project period.
    7. Personnel (10 Points)
    The extent to which the qualifications and time commitments of 
project

[[Page 5554]]

personnel are clearly documented and appropriate for implementing the 
proposal.
    8. Budget justification (not scored).
    The extent to which the budget is reasonable, clearly justified, 
and consistent with the intended use of funds.

Part C: Assessment/Evaluation Studies--Factors To Be Considered

------------------------------------------------------------------------
                     Evaluation criterion                        Points 
------------------------------------------------------------------------
1. Study protocol.............................................        45
2. Project personnel..........................................        20
3. Project management.........................................        35
4. Budget and justification...................................     (\1\)
5. Human Subjects.............................................     (\1\)
                                                               ---------
    Total Maximum Points......................................      100 
------------------------------------------------------------------------
\1\ Not scored.                                                         

Part C: Assessment/Evaluation Studies--Factors To Be Considered

    1. Study protocol (45 Points)
    The protocol's scientific soundness (including adequate sample size 
with power calculations), quality, feasibility, consistency with the 
project goals, and soundness of the evaluation plan (which should 
provide sufficient detail regarding the way in which the program will 
be implemented to facilitate replication of the program).
    The degree to which the applicant has met the CDC Policy 
requirements 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.
    2. Project personnel (20 Points)
    The qualifications, experience (including experience in conducting 
relevant studies), and time commitment of the staff needed to ensure 
that the study will be carried out.
    3. Project management (35 Points)
    Schedule for implementing and monitoring the proposed study. The 
extent to which the application documents specific, attainable, and 
realistic goals and clearly indicates the performance measures that 
will be monitored, how they will be monitored, and with what frequency. 
This section should contain enough detail to determine at the end of 
each budget year the extent to which the project is on target in 
completing the study process and outcome objectives.
    4. Budget justification (not scored).
    The extent to which the budget is reasonable, clearly justified, 
and consistent with the intended use of cooperative agreement funds.
    5. Human subjects (not scored).
    The extent to which the applicant complies with the Department of 
Health and Human Services regulations (45 CFR Part 46) regarding the 
protection of human subjects.

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 the SPOCs 
have comments they should be sent to Lisa G. Tamaroff, Grants 
Management Specialist, Grants Management Branch, Procurement and Grants 
Office, Centers for Disease Control and Prevention (CDC), 255 East 
Paces Ferry Road, NE, Atlanta, GA 30305, no later than 60 days after 
the application due date. The Program Announcement Number and Program 
Title should be referenced on the document. The granting agency does 
not guarantee to ``accommodate or explain'' state process 
recommendations it receives after that date.

Public Health System Reporting Requirement

    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 93.197.

Other Requirements

Paperwork Reduction Act

    Data collection initiated under this grant has been approved by the 
Office of Management and Budget under number 0920-0282, ``Childhood 
Lead Prevention Grant Reporting''. Exp. Date 10/98. OMB clearance for 
the data collection for the surveillance activities, ``Childhood Blood 
Lead Surveillance System OMB No. 0920-0337, Exp. Date 1/98'' is pending 
approval by OMB.

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 
form provided in the application kit.

Women and Minority Inclusion Policy

    It is the policy of the CDC to ensure that women and racial and 
ethnic groups will be included in CDC-supported research projects 
involving human subjects, whenever feasible and appropriate. Racial and 
ethnic groups are defined in OMB Directive No. 15 and include American 
Indian or Alaska Native, Asian, Black or African American, Native 
Hawaiian or Other Pacific Islander, and Hispanic or Latino. Applicants 
shall ensure that women and 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.
    In conducting the review of applications for scientific merit, 
review groups will evaluate proposed plans for inclusion of minorities 
and both sexes as part of the scientific assessment and assigned score. 
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, Friday, September 15, 1995, pages 47947-47951.

Application Submission and Deadline

    Applicants submitting for Part A (CLPP program) or Part B (CBLS 
program) please submit the original and two copies of the PHS 5161-1 
(OMB Number 0937-0189).
    Applicants submitting for Part C (additional and supplemental 
funds) please submit an original and five copies of the PHS 398.
    All applications must be submitted to Lisa G. Tamaroff, Grants 
Management Specialist, Grants Management Branch,

[[Page 5555]]

Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE., Room 300, Atlanta, GA 
30305, on or before March 31, 1998.

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 for the review process. Applicants must request a legibly 
dated U.S. Postal Service Postmark or obtain a legibly dated receipt 
from a commercial carrier or U.S. Postal Service. Private metered 
postmarks shall not be acceptable as proof of timely mailing.

2. Late Applications

    Applications which do not meet the criteria in 1.A. or 1.B. above 
are considered late applications. Late applications will not be 
considered in the current competition and will be returned to the 
applicant.
    A one-page, single-spaced, typed abstract must be submitted with 
the application. The heading should include the title of the grant 
program, project title, organization, name and address, project 
director, and telephone number.

Where to Obtain Additional Information

    To receive additional written information, call 1-888-GRANTS4. You 
will be asked to leave your name, address, and phone number and will 
need to refer to Announcement 98018. 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 Lisa G. Tamaroff, Grants Management Specialist, Grants Management 
Branch, Procurement and Grants Office, Centers for Disease Control and 
Prevention (CDC), 255 East Paces Ferry Road, NE, Room 300, Mailstop E-
13, Atlanta, GA 30305, telephone (404) 842-6796 (Internet address 
[email protected]).
    This and other CDC announcements are also 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 Number 98018 when requesting 
information and submitting an application.
    Technical assistance on CLPP program or Part C. activities may be 
obtained from Claudette A. Grant, Acting Chief, Program Services 
Section, Lead Poisoning Prevention Branch, Division of Environmental 
Hazards and Health Effects, National Center for Environmental Health, 
Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, 
NE, Mailstop F-42, Atlanta, GA 30341-3724, telephone (770) 488-7330 
(Internet address [email protected]).
    Technical assistance on CBLS program activities may be obtained 
from Sharunda D. Buchanan, Ph.D., Epidemiologist, Surveillance and 
Programs Branch, Division of Environmental Hazards and Health Effects, 
National Center for Environmental Health, Centers for Disease Control 
and Prevention (CDC), 4770 Buford Highway, NE, Mailstop F-47, Atlanta, 
GA 30341-3724, telephone (770) 488-7060 (Internet address 
[email protected]).
    Potential applicants may obtain a copy of ``Healthy People 2000'' 
(Full Report, Stock No. 017-001-00474-0) or ``Healthy People 2000'' 
(Summary Report, Stock No. 017-001-00473-1) through the Superintendent 
of Documents, Government Printing Office, Washington, DC 20402-9325, 
telephone (202) 512-1800.

    Dated: January 27, 1998.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention.

    Appendix A: Background on CDC's estimate of number and 
proportion of children at high risk for lead exposure by state.
    To provide states with general guidance about the appropriate 
amount of funding to request under this Program Announcement, CDC 
estimated the number and percentage of children with EBLLs for each 
state. CDC used a logistic-regression model to estimate the 
contribution of four major risk factors to the probability that an 
individual child would have a blood lead level (BLL) of at least 10 
g/dL. The selected risk factors were based on data from 
Phase 2 of the Third National Health and Nutrition Examination 
Survey (NHANES III, Phase 2) and included the age and race of 
children, age of housing, and family income. The model established a 
relative contribution or ``coefficient'' for each of these factors. 
These coefficients were then applied to the relevant categories of 
1990 census data for each state to produce an estimate of both the 
number and the percentage of children with elevated BLLs in the 
state.
    CDC's purpose in estimating the number and percentage of 
children with EBLLs in each state is to approximate the level of 
effort that may be required to provide prevention services to the 
entire population of a state. In accordance with this purpose, CDC 
adjusted the level of effort projected for state-level CLPP Programs 
in states with one or more locales currently funded under this grant 
program.
    To derive the funding category for each state, CDC gave twice as 
much weight to the estimated percentage of children with elevated 
BLLs as to the estimated number of children with elevated BLLs.

    Note: The categorization scheme developed for use in this 
Program Announcement is likely to be of only limited usefulness for 
other purposes. The use of an approximation is necessary because of 
the wide variation among states in the extent to which their 
pediatric populations are exposed to lead.

[FR Doc. 98-2572 Filed 2-2-98; 8:45 am]
BILLING CODE 4163-18-P