[Federal Register Volume 63, Number 92 (Wednesday, May 13, 1998)]
[Notices]
[Pages 26614-26620]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-12645]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
[Program Announcement 98046]


National Comprehensive Cancer Control Program; Notice of 
Availability of Fiscal Year 1998 Funds

Introduction

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of funds in fiscal year (FY) 1998 for cooperative 
agreements to implement comprehensive cancer control plans.
    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 area of Cancer. (To order 
a copy of ``Healthy People 2000,'' see the section ``Where To Obtain 
Additional Information.'')

Authority

    This program is authorized by Sections 317 and 1507 [42 U.S.C. 
247b] and [42 U.S.C. 300n-3] of the Public Health Service Act, as 
amended.

Smoke-Free Workplace

    CDC strongly encourages all grant recipients to provide a smoke-
free workplace and to promote the nonuse of all tobacco products, and 
Public Law 103-227, 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 the official public health 
agencies of States or their bona fide agents, including the District of 
Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, the 
Commonwealth of the Northern Mariana Islands, American Samoa, Guam, 
federally recognized Indian tribal governments, the Federated States of 
Micronesia, the Republic of the Marshall Islands, and the Republic of 
the Palau. In consultation with States, assistance may be provided to 
political subdivisions of States.
    Applicants must complete the Eligibility Assurance Form included in 
the application packet and must attach a reproducible copy of the 
State/Tribe/Territory's comprehensive Cancer Control Plan to that form. 
Only one eligible application from a State/Tribe/Territory will be 
funded. Applicants from each State/Tribe/Territory are encouraged to 
coordinate and combine their efforts prior to submitting the 
application for their State/Tribe/Territory.

Availability of Funds

    Approximately $1.5 million is available in FY 1998 to fund 
approximately 5 awards. It is expected that the average award will be 
$300,000 ranging from $250,000 to $350,000. It is expected that these 
awards will begin on or about September 30, 1998, and will be made for 
12-month budget periods within a project period of up to 4 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 as evidenced by required reports and the 
availability of funds.

Use of Funds

    These funds are intended for comprehensive cancer control and

[[Page 26615]]

should not be used to directly support other existing programs such as 
breast and cervical cancer programs, cancer registry programs, 
laboratory or clinical services, or tobacco control programs. These 
funds should be used to assist with the coordination of these and other 
categorical programs into comprehensive cancer control activities. 
Funds awarded under this program announcement may not be used to 
supplant existing program efforts.
    Comprehensive cancer control activities should adhere to current 
accepted public health recommendations by the U.S. Preventive Services 
Task Force, or current Division of Cancer Prevention and Control (DCPC) 
guidance (See Section on Where To Obtain Additional Information).
    In the event that additional federal categorical funding becomes 
available under this announcement, Grantees must coordinate and 
integrate newly funded activities into the existing National 
Comprehensive Cancer Control Program.

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 FY 1998 Department of Labor, Health and Human 
Services, and Education, and Related Agencies Appropriations Act 
(Public Law 105-78) states in Section 503 (a) and (b) that 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 legislature itself. 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

    In the United States, cancer is the second leading cause of death, 
exceeded only by heart disease. Among adults younger than 65 years, 
cancer is the leading cause of death and is rapidly overtaking heart 
disease as the primary cause of death among older Americans (Kennedy 
1994). One of every four deaths in the United States is from cancer 
with approximately 564,800 people expected to die of cancer this year 
(American Cancer Society 1998). The overall cancer death rate has been 
steadily rising in the United States during the last 50 years. The age-
adjusted death rate in 1950 was 127.7 per 100,000 population (National 
Center for Health Statistics 1968); it rose to 129.9 per 100,000 in 
1995 (National Center for Health Statistics 1997).
    While cancer currently is a major cause of morbidity and mortality 
in the United States, a large proportion of cancer could be controlled 
through prevention, early detection, and treatment. In recent years, 
DCPC has worked with state and local health agencies to increase the 
number and quality of cancer-related programs that are available to the 
U.S. population. New organizational structures, increased professional 
expertise, improved understanding of the challenges of delivering 
community-based health education and health promotion and an increased 
ability to demonstrate program accountability to program funders have 
reinforced the public health infrastructure available for cancer 
prevention and control at the national, State and community levels. In 
addition, in 1997, an American Cancer Society-appointed Blue Ribbon 
Advisory Group on Community Cancer Control recommended that prevention 
be a primary goal and focus. (American Cancer Society 1997).
    The majority of the programs developed by CDC are categorical in 
nature, i.e., built around specific cancer sites or risk factors. For 
example, CDC has developed important initiatives and programs to 
address breast and cervical cancer, skin cancer, colorectal cancer, 
prostate cancer, oral cancer, nutrition and physical activity, and 
tobacco control; these categorical programs indicate impressive 
accomplishments in their areas. However, coordination and collaboration 
among these programs are uncommon, often leading to duplication of 
effort and missed opportunities for cancer prevention and control at 
the community level.
    In 1994, DCPC initiated discussions related to the coordination and 
integration of cancer prevention and control programs across 
categorical boundaries. DCPC sponsored a number of activities to 
explore options for comprehensive cancer control. One of the key tasks 
was to develop a working definition of comprehensive cancer control. 
The following definition was determined to be encompassing and 
appropriate for future planning and implementation activities:
    Comprehensive cancer control--an integrated and coordinated 
approach to reduce the incidence, morbidity and mortality [of cancer] 
through prevention, early detection, treatment, rehabilitation, and 
palliation.

Purpose

    The purpose of this program is to support States/Tribes/Territories 
in the implementation of up-to-date State/Tribe/Territory wide 
comprehensive cancer control plans. (See Glossary for definitions of 
comprehensive cancer control plan and comprehensive cancer control 
program.)

Program Requirements

    Recipients of this funding should adhere to current accepted public 
health recommendations based on the U.S. Preventive Services Task 
Force, or current DCPC guidance (See Section on Where To Obtain 
Additional Information).
    In conducting activities to achieve the purpose of this program, 
the recipient of this cooperative agreement will be responsible for the 
activities under A. (Recipient Activities), and CDC will be responsible 
for conducting activities under B. (CDC Activities).

A. Recipient Activities

    1. Identify and hire necessary key staff to implement the 
comprehensive cancer control plan.
    2. Maintain or enhance a broad-based state/tribe/territorywide 
cancer control coalition that includes representation from throughout 
the state/tribe/territory health department, as well as key private, 
professional, voluntary, and nonprofit cancer control organizations, 
policymakers, consumers (including cancer survivors), payors, media, 
State and federal agencies, cancer registries, research and academic 
institutions, schools, etc.
    3. Implement priorities as established by the State/Tribe/
Territory's comprehensive cancer control plan, which provides a 
framework for

[[Page 26616]]

planning and action to reduce the burden of cancer in the State/Tribe/
Territory. Implementation should be guided by goals and objectives 
documented in the implementation plan included in this application.
    4. Promote collaboration and coordination among existing State/
Tribe/Territory-based surveillance systems (e.g., the statewide Central 
Cancer Registry, Surveillance, Epidemiology, and End Results, (SEER), 
vital statistics, and other databases, including Behavioral Risk Factor 
Surveillance System (BRFSS), for use in monitoring changes in cancer 
disease burden and programmatic impact of the comprehensive cancer 
control efforts. Data should be used for program modifications and 
improvements, evaluation, and updating the comprehensive cancer control 
plan, as appropriate.
    5. Evaluate progress and impact of the program based on a 
systematic evaluation plan. In addition to evaluating progress in 
meeting goals, process and impact objectives as stated in the 
implementation plan, the programs should develop performance indicators 
to use as benchmarks for improvement and to determine the success of 
the overall comprehensive cancer control effort.
    6. Promote the development and dissemination of information and 
education programs that will contribute to comprehensive cancer 
control; and participate in CDC-developed national cancer prevention, 
early detection, and control campaigns. Programs should use existing 
education resources as well as develop materials and activities that 
address specific needs of their populations, as necessary and 
appropriate. School health education and policies should be considered 
as part of these strategies. In addition to addressing educational 
needs of the targeted populations, programs should also consider 
activities that attempt to make individual, policy, organizational or 
environmental interventions and changes that can encourage primary 
prevention at all levels, e.g., organizational changes that can 
reinforce and support individual behavior changes.
    7. Participate in CDC-sponsored trainings, meetings, site visits, 
and conferences.

B. CDC Activities

    1. Convene meetings for information-sharing or training among 
recipients of cooperative agreements.
    2. Facilitate the exchange of information and collaboration among 
recipients.
    3. Disseminate to recipients relevant state-of-the-art research 
findings and public health recommendations related to comprehensive 
cancer control.
    4. Provide ongoing guidance, consultation, and technical assistance 
in conducting Recipient Activities.
    5. Conduct site visits to assess program progress, and mutually 
resolve problems, as needed, and coordinate reverse site visits to CDC 
in Atlanta, Georgia.
    6. Identify and develop national cancer prevention and control 
campaigns and materials that can be integrated into comprehensive 
cancer control programs; facilitate coordination between programs and 
CDC on national campaigns.

Technical Reporting Requirements

    An original and two copies of an annual progress report must be 
submitted 30 days after the end of each budget period. These progress 
reports must include: (1) a comparison of actual accomplishments to the 
goals and objectives established for the period; (2) activities and 
other issues to be addressed during the subsequent reporting period. 
The final performance report is required no later than 90 days after 
the end of the project period.
    Annual financial status report (FSR) must be submitted no later 
than 90 days after the end of each budget period. The final financial 
status and progress reports are required no later than 90 days after 
the end of the project period. All reports are submitted to Grants 
Management Branch, CDC.

Application Content

    All applicants must develop their applications in accordance with 
information contained in this program announcement and the instructions 
below. Applications should not exceed 30 double-spaced pages (no 
smaller than 10 point type) including budget and justification. 
Applicants should also submit appendices (including CVs, job 
descriptions, organizational chart, and any other supporting 
documentation), which should not exceed an additional 20 pages. All 
materials must be provided in an unbound, one-sided, 8\1/2\ x 11'' 
print format, suitable for photocopying (i.e., no audiovisual 
materials, posters, tapes, etc.). A reproducible copy of the State/
Tribe/Territory's comprehensive cancer control plan (attached to the 
Eligibility Assurance Form), and the letters of support should be 
included in separate tabbed sections of the application. (The 
comprehensive cancer control plan and letters of support are not 
included in the page limit for the application or appendices.)

I. Executive Summary

    The applicant should provide a clear, concise one to two page 
written summary to include:
    A. The need for implementing the comprehensive cancer control plan.
    B. The major proposed objectives and activities for implementation 
of the comprehensive cancer control plan.
    C. The requested amount of federal funding.
    D. Applicant's capability to implement the comprehensive cancer 
control plan.

II. Background and Need

    The applicant should describe:
    A. The cancer disease burden for their State/Tribe/Territory:
    1. The most recently available State/Tribe/Territory, age-adjusted, 
overall cancer incidence and mortality rates by age, gender, and racial 
and ethnic groups. Please cite the source for and time period covered 
by these data.
    2. The estimated State/Tribe/Territory cancer incidence and 
mortality rates for 1998.

(Please refer to the section on ``Where To Obtain Additional 
Information'' for possible data sources.)

    B. Relevant experiences in the development and implementation of 
cancer prevention and control programs.
    C. Relevant experiences in coordination and collaboration between 
and among existing programs.
    D. Existing initiatives, capacity, and infrastructure (e.g., 
coalition and partnerships; surveillance activities and systems; 
evaluation activities; information, media and health communications, 
education and outreach strategies) on which a coordinated comprehensive 
cancer control program will be established.
    E. Description of the need for comprehensive cancer control funding 
to enhance existing efforts.

III. Collaborative Partnership and Community Involvement

    The applicant should include:
    A. A description of proposed linkages to coordinate within the 
State/Tribe/Territory health department (e.g., across risk factors, 
categorically funded programs, disciplines), with other key private, 
professional, voluntary, and non-profit cancer control organizations, 
policymakers, consumers (including cancer survivors), payors, federal, 
State and local agencies, research and academic institutions, schools, 
and other groups, agencies, and businesses in the community that 
provide health care and related human services.

[[Page 26617]]

    B. A description of the proposed broad-based State/Tribe/Territory 
wide coalition that will advise and support the program, including the 
identification of current members or proposed representatives, their 
charge, and proposed roles and responsibilities. Taking a broad cancer 
prevention and control perspective, the State/Tribe/Territory should 
consider including a wide range of representatives from risk factor and 
other public health programs that address cancer-related issues such 
as, nutrition, environmental, oral health, and school health 
activities. Specific subcommittees and the rationale for these 
subcommittees of the coalition should be described.
    C. Letters of support (in a separate tabbed section of the 
application) that indicate the nature and extent of existing or planned 
collaborative support.

IV. Cancer Control Plan

    The applicant should:
    A. Submit a copy of the (a) current existing state/tribe/territory 
wide comprehensive cancer control plan, or (b) a current detailed final 
draft plan. Attach a reproducible, one-sided, 8\1/2\ x 11'' unbound 
copy of the plan, to the completed Eligibility Assurance Form. A 
comprehensive cancer control plan should include:
    1. An assessment of cancer burden in the State/Tribe/Territory 
using population-based data.
    2. Short-term and long-term goals and objectives to address cancer 
control issues within the State/Tribe/Territory based on identified 
needs.
    3. Proposed strategies to meet the objectives.
    4. An assessment of existing and needed resources to implement the 
comprehensive cancer control priorities.
    5. The full range of cancer prevention and control activities, 
including primary prevention, early detection, diagnosis, treatment, 
rehabilitation and palliation.
    B. Describe the process by which the plan was developed. (If the 
plan is in draft, describe the process for assuring readiness for 
implementation by September 30, 1998.) Include a description of the 
participating agencies' and organizations' involvement in the 
development of the plan. Clearly describe a mechanism to review, 
evaluate, and update the plan to meet evolving needs.
    C. Describe who will be responsible for maintaining the 
comprehensive cancer control plan and assuring that the coalition is 
involved throughout the process, and that comprehensive cancer control 
efforts proceed according to the State/Tribe/Territory's plan.

V. Implementation of the Comprehensive Cancer Control Plan

    The successful coordination and integration of cancer activities, 
based on the comprehensive cancer control plan, requires that 
priorities be determined based on a clear data-driven rationale and 
justification.
    The applicant should include an implementation plan that:
    A. Describes the process for determining priorities to be addressed 
in implementing the comprehensive cancer control plan, the process for 
assuring that these decisions are data-based and grounded in sound 
science, and the role of the coalition and/or collaborators in the 
priority-setting process.
    B. Includes specific, measurable, attainable, realistic, and time-
framed process and outcome objectives designed to achieve goals 
identified in the comprehensive cancer control plan. The implementation 
plan for this RFA need not address each goal and objective outlined in 
the comprehensive cancer control plan; the applicant should make clear 
how goals and objectives resulting from the priority-setting process 
relate to the comprehensive cancer control plan.
    C. Provides a description of the process for implementing goals and 
objectives for the identified priorities of the comprehensive cancer 
control plan. This should include discrete timeframes; responsible 
agencies, organizations, or organizational units; and activities 
proposed to meet the objectives within the comprehensive cancer control 
plan. It should also include a description of how the proposed 
activities will facilitate coordination and cooperation among existing 
categorical program efforts. The applicant should include goals for all 
four years, and specific objectives for Year 01.
    D. Describes how surveillance data will be integrated into program 
activities and used to assess program progress, and inform program 
decision making.
    Description should include evidence that existing surveillance 
systems enable programs to do the following:
    1. Collect population-based information on the demographics, 
incidence, staging of cancer at diagnosis, morbidity and mortality from 
cancer. Mechanisms should be in place to ensure timeliness, quality, 
and completeness of data.
    2. Identify segments of the population who are at higher risk for 
incidence, morbidity, and mortality.
    3. Identify factors contributing to the disease burden, such as 
behavioral risk factors and limited or inequitable access to services.
    4. When appropriate, monitor the number and characteristics of 
people served by relevant programs.
    5. When appropriate, develop linkages between the above-mentioned 
data bases and routinely monitor to determine the effectiveness of 
interventions.
    E. Includes the current or proposed plan for evaluating (1) the 
program's progress in meeting specific objectives outlined in the 
implementation plan, and (2) overall success of the comprehensive 
cancer control effort, based on indicators established by the 
applicant. Describe the types of indicators to be used to assess 
outcomes such as coordination, integration and collaboration that have 
occurred as a result of this funding. Such indicators might assess 
organizational or institutional changes, reduced duplication of effort, 
environmental and policy changes. Baseline measures should be 
identified and assessed, to allow for comparisons after implementation 
has begun. For each type of evaluation, specify the kind of data/
indicator that will be used, how the data will be obtained, how 
information will be used to improve the overall program, as well as 
individual program components, who is responsible for each evaluation 
task, and a time line for accomplishing each evaluation task.
    F. Describes proposed information and education efforts. Identify 
the mechanisms through which information, material, and successful 
strategies will be consistently and systematically shared and 
disseminated at the State/Tribe/Territory and local levels, as well as 
with other cooperative agreement recipients. Include in this 
description a discussion of plans for collaborating with CDC on 
national campaigns or educational efforts.
    G. Describes mechanism for assuring that the core components of a 
comprehensive cancer control program including primary prevention/risk 
factor reduction; education, outreach, health communications; 
screening, diagnostic, and treatment services; surveillance; and 
evaluation are consistent with accepted science and prevailing 
standards of public health practice. The primary prevention components 
should address risk factors that will have the greatest impact on 
reducing the overall disease burden of cancer and are not limited to 
prevention activities of the specific cancers addressed in the State/
Tribe/Territory's comprehensive cancer control program.

[[Page 26618]]

    H. Describes existing programs funded by other sources that will be 
coordinated with the comprehensive cancer control effort.

VI. Management and Organization

    The applicant should:
    A. Submit a management plan that includes a description of the 
proposed management structure that addresses the use of qualified and 
diverse technical, program, and administrative staff (including in-kind 
staff), organizational relationships including lines of authority, 
internal and external communication systems, and a system for sound 
fiscal management. Minimal staffing should include a full-time program 
coordinator. The management structure description should include 
discussion of the integration and coordination of risk factor and 
cancer-related programs and activities. It is important that the 
management plan address how coordination and cooperation among existing 
categorical program efforts will be facilitated, while allowing each 
program to maintain individual integrity and identity.
    B. Provide (in the appendices) a copy of the organizational chart 
indicating the placement of the proposed program in the department or 
agency. The chart should clearly demonstrate internal linkages 
necessary for comprehensive cancer control planning, implementation and 
evaluation.
    C. Provide (in the appendices) CVs and job descriptions of key 
staff to be partially or fully funded through this RFA, as well as any 
staff to be providing in-kind support. Applicant should clearly 
indicate who is responsible for overall direction of the program.

VII. Budget With Justification

    The applicant should provide a detailed budget request and complete 
line item justification of all proposed operating expenses consistent 
with the Recipient Activities. If in-kind contributions are being 
provided by the applicant, these should be documented.
    The annual budget should include funds for two staff members to 
make two two-day trips to Atlanta.

Non-Competing Continuation Application Content

    In compliance with 45 C.F.R. 92.10(b)(4), as applicable, 
noncompeting continuation applications submitted within the project 
period need only include:
    A. A progress report describing the accomplishments made from award 
date to the date of the continuation application. These progress 
reports must include: (1) a comparison of actual accomplishments with 
the goals and objectives established for the period, and
    (2) other activities and issues to be addressed during the 
subsequent reporting period.
    B. Any new or significantly revised items or information 
(objectives, scope of activities, operational methods, evaluation, 
etc.) not included in the Year 01 application.
    C. An annual budget and justification. Existing budget items that 
are unchanged from the previous budget period do not need 
rejustification. Simply list the items in the budget and indicate that 
they are continuation items. Supporting justification should be 
provided where appropriate.

Evaluation Criteria (Total 100 Points)

    Objective Review panels evaluate the scientific and technical merit 
of applications and their responsiveness to the information requested 
in the Application Content section above. Applications will be reviewed 
and evaluated according to the following criteria:

I. Background and Need (10 points)

    The extent of need based on disease burden by age, gender, and 
racial and ethnic groups, mortality rates, incidence, cancer program 
experience, existing capacity and infrastructure, and funding need.

II. Collaborative Partnership and Community Involvement (15 points)

    The comprehensiveness and appropriateness of:
    A. Existing or proposed linkages within and outside the State/
Tribe/Territory health department to coordinate diverse cancer control, 
risk factor and other primary prevention programs and activities among 
various agencies, organizations, professional groups, and individuals.
    B. The current or proposed broad-based State/Tribe/Territory wide 
coalition to advise and support the program, including defined roles, 
responsibilities, and specified subcommittees.
    C. Letters of support that indicate the nature and extent of 
existing or planned collaborative support.

III. Cancer Control Plan (15 points)

    The quality of the comprehensive cancer control plan in terms of:
    A. An integrated and coordinated State/Tribe/Territory wide 
approach to prevention, early detection, treatment, rehabilitation, and 
palliation of cancer; assessment of the State/Tribe/Territory's cancer 
burden; short-term and long-term goals, objectives, and strategies to 
address cancer control issues; assessment of existing and needed 
resources to develop the comprehensive cancer control program; the full 
range of cancer prevention and control activities, including primary 
prevention, early detection, diagnosis, treatment, rehabilitation and 
palliation.
    B. The extent to which a broad range of partners and stakeholders 
are included throughout the process to develop, implement, review, and 
update the plan; mechanisms to review, evaluate and update the plan to 
meet evolving needs, and personnel who will be responsible for 
maintaining the plan, assuring that it is current and regularly 
reviewed and updated are clearly identified.

IV. Implementation of the Comprehensive Cancer Control Plan (35 points)

    The extent to which the applicant's implementation plan describes:
    A. Process, justification, and rationale for priorities established 
for implementation.
    B. Specific, measurable, realistic, time-framed objectives based on 
the comprehensive cancer control plan.
    C. The process for implementing priorities identified in the plan, 
to include discrete time frames, responsible agencies and 
organizations, linkages of activities to objectives, and how the 
proposed activities will facilitate coordination and collaboration 
among existing categorical program efforts.
    D. How surveillance data will be integrated into program activities 
and used to assess program progress and assist program decision making; 
the surveillance systems and collection of relevant and appropriate 
population-based information on the demographics, behavioral, disease 
burden and incidence, etc.; and any linkages between databases and 
routine monitoring to determine effectiveness of interventions.
    E. Plans for evaluating the program's progress in meeting specific 
objectives outlined in the implementation plan, and overall success of 
the comprehensive cancer control effort.
    F. Proposed information and education efforts, including 
collaborating with CDC on national campaigns.
    G. Methods for assuring that: the core components of a 
comprehensive cancer control program including primary prevention/risk 
factor reduction; education, outreach, and health communications; 
screening, diagnostic, and treatment services; surveillance;

[[Page 26619]]

and evaluation are consistent with accepted science and prevailing 
public health practice; the primary prevention components address risk 
factors that will have the greatest impact on reducing the overall 
disease burden of cancer and are not limited to prevention activities 
of the specific cancers addressed in the State/Tribe/Territory's 
comprehensive cancer control program.
    H. Description of other existing programs funded by other sources 
that will be coordinated with the comprehensive cancer control effort.

V. Management and Organization (25 points)

    A. The feasibility and clarity of the proposed management plan that 
addresses the use of qualified and diverse technical, program, and 
administrative staff, organizational relationships including lines of 
authority, internal and external communication systems, cooperation and 
coordination among categorical cancer-related programs, and a system 
for sound fiscal management.
    B. The appropriateness of the organizational structure and the 
existing and proposed internal and external linkages.
    C. The quality and appropriateness of CVs and job descriptions of 
current and proposed key staff, to include who is responsible for 
overall direction of the program.

VI. Budget With Justification (Not Weighted)

    The extent to which the proposed budget is adequately justified, 
reasonable, and consistent with this program announcement.

Executive Order 12372 Review

    Applications are subject to Intergovernmental Review of Federal 
Programs as governed by Executive Order 12372. This order sets up a 
system for State/Territory/Tribe and local review of proposed federal 
assistance applications. Applicants should contact their State Single 
Point of Contact (SPOC) as early as possible to alert them to expected 
announcements of cooperative agreement funds 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 of each 
State. A current list of SPOCs is included in the application kit. 
Indian territories are strongly encouraged to request tribal government 
review of the proposed application. If tribal governments have any 
tribal process recommendations or if SPOCs have any State process 
recommendations on applications submitted to CDC, they should send them 
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., Room 305, Mailstop E-
18, Atlanta, GA 30305, no later than 60 days after the application 
deadline date. 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 or tribal 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 93.919.

Other Requirements

Paperwork Reduction Act

    Projects that involve the collection of information from 10 
individuals or more and funded by cooperative agreement will be subject 
to review by the Office of Management and Budget (OMB) under the 
Paperwork Reduction Act.

Application Submission and Deadline

    The original and two copies of the completed application Form CDC 
0.1246(E) (OMB Number 0348-0043) 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., Room 314, Mailstop E-18, Atlanta, GA 30305 
on or before July 1, 1998.
    1. Applications shall be considered as meeting the deadline if they 
are either:
    a. Received on or before the stated 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 shall not be accepted as proof of timely mailing.)
    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 in the current competition and will 
be returned to the applicant.
    3. Acceptable Materials. Applicants must send all materials in an 
unbound, one-sided 8\1/2\ x 11'' printed format, suitable for 
photocopying. All other application materials will not be reviewed.
    4. Only one eligible application from a State/Tribe/Territory will 
be funded. Applicants from each State/Tribe/Territory are encouraged to 
coordinate and combine their efforts prior to submitting the 
application for their State/Tribe/Territory.

Where To Obtain Additional Information

    Complete information on application procedures is contained in the 
application package. Business management technical assistance may be 
obtained from Gladys T. Gissentanna, Grants Management Specialist, 
Grants Management Branch, Procurement and Grants Office, Centers for 
Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE., 
Room 314, Mailstop E-18, Atlanta, GA 30305, telephone (404) 842-6801; 
by fax (404) 842-6513; by Internet or CDC WONDER electronic mail at 
[email protected].
    Programmatic technical assistance may be obtained from Jeannette 
May, MPH, or Diane Narkunas, MPH, Program Services Branch, Division of 
Cancer Prevention and Control, National Center for Chronic Disease 
Prevention and Health Promotion, Centers for Disease Control and 
Prevention (CDC), 4770 Buford Highway, NE., Mailstop K-57, Atlanta, GA 
30341-3717, telephone (404) 488-4880 and by fax (404) 488-4727; by 
Internet or CDC WONDER electronic mail at [email protected] or [email protected].
    Please refer to Program Announcement Number 98046 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.
    Copies of the U.S. Preventive Services Task Force Guide to Clinical 
Preventive Services, 2nd ed. (Williams & Wilkins, October 1995) 
referenced above may be obtained by calling 1-800-358-3538, or from the 
world wide web at http://www.wwilkins.com/books/data/0-683-08508-
5.html.

[[Page 26620]]

    Data on cancer incidence and mortality can be obtained from the 
following sources:
    1. The State Cancer Registry.
    2. The American Cancer Society, Facts and Figures, 1998. 1-800-ACS-
2345.
    3. Mortality Statistics Branch, Division of Vital Statistics, 
National Center for Health Statistics, Centers for Disease Control and 
Prevention at (301) 436-8884, fax (301) 436-7066. Available at http://
www.cdc.gov/nchswww/about/major/dvs/mortdata.htm.
    4. SEER Cancer Statistics Review, 1973-1994, NIH Pub. No. 97-2789. 
Available at http://www-seer.ims.nci.nih.gov/Publications/CSR7394/
index.html or by calling the Cancer Statistics Branch Cancer Control 
Research Program Division of Cancer Prevention and Control, National 
Cancer Institute at (301) 496-8510.
    CDC suggests using the Internet, following all instructions in this 
announcement and leaving messages on the contact person's voice mail 
for more timely responses to any questions.

Eligibility Assurance Form

    All applicants MUST complete this check-list and attach appropriate 
documentation supporting eligibility (the state/tribe/territory wide 
comprehensive cancer control plan). The plan must be attached to this 
check-list, should not be incorporated into the body of the application 
or the appendices, and therefore does not affect the page limit for the 
application (30 pages) or appendices (20 pages). A copy of this form, 
with an attached reproducible plan, should be included with each copy 
of the application as a separate tabbed section.

____A state/tribe/territory wide comprehensive cancer control plan has 
been developed. Plan is either:
    ____an existing up-to-date plan ready for implementation, or
    ____an up-to-date detailed final draft ready for implementation by 
September 30, 1998.

    At a minimum,

    ____Plan documents an integrated and coordinated state/tribe/
territory wide approach to prevention, early detection, treatment, 
rehabilitation, and palliation of cancer (i.e., not a summation or 
compilation of categorical risk factor/specific cancer programs).
    ____ Plan identifies priorities to be addressed based on needs 
identified through assessment of the burden of the major detectable/
preventable cancers in the State/Tribe/Territory.
____Copy of the State/Tribe/Territory wide comprehensive cancer control 
plan document is attached. (A reproducible, unbound, one-sided, 8\1/2\ 
x 11'' copy of the plan should be attached to this form.)

Glossary

    Terms are defined by DCPC in this Glossary to clarify issues for 
applicants under this RFA only. They are not meant to apply to all DCPC 
or CDC programs, activities, or RFAs.
    Comprehensive Cancer Control: An integrated and coordinated 
approach to reduce the incidence, morbidity, and mortality [of cancer] 
through prevention, early detection, treatment, rehabilitation, and 
palliation.
    Comprehensive Cancer Control Plan: Document that is developed as an 
optimal blueprint for achieving comprehensive cancer control in that 
State/Tribe/Territory. It should address information on cancer burden; 
short-and long-term goals and objectives; proposed strategies to meet 
objectives; assessment of existing and needed resources; and a plan for 
promoting access to full range of cancer control services.
    At a minimum, a Comprehensive Cancer Control Plan: (1) documents an 
integrated and coordinated state/tribe/territory wide approach to 
prevention, early detection, treatment, rehabilitation, and palliation 
of cancer (i.e., not a summation or compilation of categorical risk 
factor/specific cancer programs); and (2) identifies the priorities to 
be addressed based on an assessment of the burden of the major 
detectable/preventable cancers in the State/Tribe/Territory.
    Comprehensive Cancer Control Program: Based on goals and objectives 
established in the comprehensive cancer control plan, the overall set 
of actions that are conducted with available resources to translate the 
optimal plan into feasible reality.
    Implementation: Conducting activities that are designed to achieve 
goals and objectives outlined in the Comprehensive Cancer Control Plan. 
Implementing the Plan is the same thing as conducting comprehensive 
cancer control activities or programs. For the purposes of programs 
funded under this RFA, implementation of the plan does not require that 
all goals and objectives in the State/Tribe/Territory wide 
comprehensive cancer control plan be implemented; implementation will 
be guided by the goals and objectives in the implementation plan 
developed for this RFA.
    Indicator: A performance measure used to track critical processes 
over time to signify progress toward a particular desired outcome of 
the program. For example, one ``indicator'' for better coordination 
among categorical programs might be a certain number of meetings held 
among categorical program staff to assure that efforts are being 
coordinated. Another ``indicator'' for the same outcome might be that 
each related program has a representative on the coalition that advises 
and directs the program.
    State/Tribe/Territory wide: Covering the entire State/Tribe/
Territory, rather than just limited 34 metropolitan or county areas 
within the State/Tribe/Territory. For example, State/Tribe/Territory 
wide comprehensive cancer control plan addresses cancer, programs, 
activities, and services throughout the State/Tribe/Territory.
    U.S. Preventive Services Task Force Guide to Clinical Preventive 
Services, 2nd ed.: The Guide clearly outlines and establishes, for the 
clinician, the current state of research on the efficacy of the major 
preventive interventions. A well-specified methodology based on 
scientific evidence is used to assess efficacy. Based on the work of a 
distinguished panel of nationally recognized experts, and reviewed by 
more than 650 federal and nonfederal experts, it provides 
recommendations on screening, counseling, and immunizations according 
to patients' personal characteristics and health risk factors.

    Dated: May 7, 1998.
Joseph R. Carter,
Acting Associate Director for Management and Operations, Centers for 
Disease Control and Prevention (CDC).
[FR Doc. 98-12645 Filed 5-12-98; 8:45 am]
BILLING CODE 4163-18-P