[Federal Register Volume 63, Number 172 (Friday, September 4, 1998)]
[Notices]
[Pages 47301-47303]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-23995]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Special Projects of National Significance; Integrated Service 
Delivery Model

AGENCY: Health Resources and Services Administration.

ACTION: Notice of limited competition for grant funds.

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SUMMARY: The Health Services Administration (HRSA) announces that 
approximately $100,000 is available for grants from the Special 
Projects of National Significance (SPNS) Program, funded under the 
authority of Section 2691 of the Public Health Service Act, as 
established by the Ryan White Care Act Amendments of 1996, Public Law 
104-148, dated May 20, 1996.
    These awards will be limited to Los Angeles County, California. 
Applicants may apply for project periods of up to 3 years. The purpose 
of this limited competition is to support the development and 
evaluation of models of care that (a) target the African American 
community in Los Angeles County, (b) can be replicated in other similar 
localities, and (c) address the formal linkage and integration of HIV 
ambulatory medical care (including primary medical care) and mental 
health, substance abuse treatment and/or other critical HIV services.
    The SPNS Program is designed to demonstrate and evaluate innovative 
and potentially replicable HIV service delivery models. The authorizing 
legislation specifies three SPNS Program objectives: (1) to assess the 
effectiveness of particular models of care; (2) to support innovative 
program design; and (3) to promote replication of effective models. The 
SPNS program will provide technical assistance and support for 
evaluation studies.

DATES: Applications for these announced grants must be received in the 
Grants Management Branch by the close of business September 24, 1998 to 
be considered for competition. Applications will meet the deadline if 
they are either (1) received on or before the deadline date or (2) 
postmarked on or before the deadline date, and received in time for 
submission to the objective review panel. A legibly dated receipt from 
a commercial carrier or U.S. Postal Service will be accepted as proof 
of timely mailing. Applications received after the deadline will be 
returned to the applicant.

ADDRESSES: Grant application kits may be obtained from the HRSA Grants 
Application Center by calling 1-888-333-HRSA. Additional information 
regarding business, administrative, and fiscal issues related to the 
awarding of grants under this Notice may be requested from Mr. Neal 
Meyerson, Grants Management Branch, HIV/AIDS Bureau, Health Resources 
and Services Administration, 5600 Fishers Lane, Room 7-27, Rockville, 
Maryland 20857. The telephone number is (301) 443-5906 and the FAX 
number is (301) 594-6096. Applicants for grants will use Form PHS 5161-
1, approved under OMB Control No. 0937-0189. Completed applications 
should be sent to the Grants Management Officer, c/o HRSA Grants 
Application Center, 40 West Gude Drive, Rockville, Maryland 20850.

FOR FURTHER INFORMATION: Additional technical information may be 
obtained from the Office of Science and

[[Page 47302]]

Epidemiology, HIV/AIDS Bureau, Health Resources and Services 
Administration, 5600 Fishers Lane, Room 7A-07, Rockville, Maryland 
20857. The telephone number is (301) 443-6560 and the FAX number is 
(301) 594-2511.

SUPPLEMENTARY INFORMATION: The SPNS Program endeavors to advance 
knowledge and skills in HIV services delivery, stimulate the design of 
innovative models of care, and support the development of effective 
delivery systems for these services. SPNS accomplishes its purpose 
through funding and technical support of innovative HIV service 
delivery models.
    The SPNS Program supports innovative projects for which 
implementation, utilization, costs, and outcomes can be evaluated 
rigorously. Proposals will be expected to adequately define and justify 
the need, innovative nature, and evaluation methodology of the proposed 
model of services. These funds should be used to create and/or evaluate 
models of care that would likely not exist or be evaluated without SPNS 
support, or that would extend the care model to previously underserved 
or unserved populations defined either geographically or 
demographically.
    SPNS Program funds cannot be used for expenses related to the 
provision of medical care, supportive services, or any other expenses 
currently reimbursed, subsidized or eligible for reimbursement through 
third party payers, grants awarded under Titles I-IV of the Ryan White 
CARE Act, or other grant and foundation sources.
    Applications will be accepted that propose to demonstrate and 
evaluate an integrated service delivery for persons with HIV disease 
and provide formal linkage and integration of primary health care with 
mental health, substance abuse treatment and other critical HIV 
services in Los Angeles County. Projects should provide comprehensive 
services to African Americans with HIV disease in facilities or clinics 
that primarily serve this population and should focus on harm reduction 
services and the provision of culturally, socially, and linguistically 
appropriate care and care management. Project evaluations should assess 
client, provider, and organizational outcomes and satisfaction of those 
in care.

Review Criteria

    Applications submitted to the SPNS program under this announcement 
will be reviewed and rated by an objective review panel. Criteria for 
the technical review of applications will include the following 
factors:

Factor 1: Justification of Need (10 Points)

    Adequacy of demonstrated knowledge of the local HIV service 
delivery system and the adequacy of the justification of need within 
the Los Angeles County African American community and target population 
for the proposed integration model. The extent to which the applicant's 
justification of need goes beyond documenting the existence of an 
available population in need of HIV services and describes what is 
innovative about the proposed model, how this model will be of benefit 
to the population in need, and its potential to advance knowledge in 
the HIV service delivery field. The adequacy of the discussion about 
whether or not this or similar models have been evaluated in published 
literature or reports. The extent to which the applicant identifies 
past/existing/future systemic or programmatic issues that have 
contributed to a fragmented service delivery system and how this model 
will result in a more integrated system of care. Consistency with the 
Statewide Coordinated Statement of Need.

Factor 2: Description of Proposed HIV Service Integration Model (25 
Points)

    The extent of the feasibility and clarity of the description, 
appropriateness, innovative quality, and potential for evaluation, 
replication and dissemination of the proposed model. The amount of 
emphasis given to the definitive integration of services within the 
African American Community to ensure the delivery of a comprehensive 
spectrum of care to persons with HIV disease. The extent to which the 
identification of providers and services integrated by the model is 
described. The adequacy of the discussion of the rationale for the 
selection of providers and services integrated by the proposed model.

Factor 3: Description of the Program Plan (20 Points)

    Comprehensiveness of the program plan as described in clearly 
stated goals, time-limited and measurable objectives for each goal, 
activities directly related to each objective, and a time line that 
shows the schedule of critical program and evaluation activities. The 
extent to which the applicant demonstrates access to the proposed 
target population and an appropriate process for maintaining client 
confidentiality throughout the project period.

Factor 4: Description of Evaluation Plan (20 points)

    Thoroughness, feasibility and appropriateness of the project's 
evaluation design from a methodological and statistical perspective. 
The extent to which the design of the evaluation allows a generalized 
conclusion regarding the outcomes of the integration model and its 
suitability for replication in other African American communities. The 
adequacy of the plan to assess HIV-related health outcomes among the 
population serviced and followed, and the anticipated impact from a 
community perspective.

Factor 5: Description of Dissemination (15 Points)

    The extent to which the applicant demonstrates past involvement 
with disseminating information about HIV service delivery by describing 
dissemination activities to date (e.g., presenting and publishing 
findings through reports and papers, training, or technical 
assistance). The adequacy and feasibility of the preliminary 
dissemination plan, designed to fully share knowledge resulting from 
this project with relevant audiences, particularly in the African 
American community.

Factor 6: Description of Organizational Capacity (10 points)

    Competency of the applicant organization in terms of fiscal, 
program management, and evaluation, as evidenced by (a) the consistency 
between the proposed level of effort and the budget justification; (b) 
skill level and time commitment required in the personnel 
specifications for program and evaluation staff; (c) the adequacy of 
resources proposed to conduct a quality evaluation of the project and 
dissemination of the project's findings; (d) the qualifications and 
experience of the proposed evaluation staff; and (e) appropriate 
confidential handling of clients' medical, social service, and 
epidemiological data. Extent of documentation demonstrating current and 
proposed coordination, formal collaboration, and specific linkages with 
related medical, health and support service activities within the 
project's catchment area.

Other Grant Information

Allowable Costs

    The basis for determining allocable and allowable costs to be 
charged to PHS grants is set forth in 45 CFR part 74, subpart Q and 45 
CFR part 92 for State, local or tribal governments. The four separate 
sets of cost principles prescribed for public and private nonprofit 
recipients are OMB Circular A-87 for State, local or tribal

[[Page 47303]]

governments; OMB Circular A-21 for institutions of higher education; 45 
CFR part 74, appendix E for hospitals; and OMB Circular A-122 for 
nonprofit organizations.

Reporting and Other Requirements

    A successful applicant under this notice will submit semi-annual 
activity summary reports in accordance with provisions of the general 
regulations which apply under 45 CFR part 74, subpart 74.51, 
``Monitoring and Reporting Program Performance,'' with the exception of 
State and local governments to which 45 CFR part 92, Subpart C 
reporting requirements apply. Also, grantees must be prepared to 
collaborate with other grantees on the design and implementation of 
project evaluations which may include multi-site evaluation studies.

Public Health System Reporting Requirements

    This program is subject to the Public Health System Reporting 
Requirements which have been approved by the Office of Management and 
Budget under No. 0937-0195. Under these requirements, any community-
based, nongovernmental applicant must prepare and submit a Public 
Health System Impact Statement (PHSIS). The PHSIS is intended to keep 
State and local health officials apprised of proposed health services 
grant applications submitted from within their jurisdictions.
    Community-based, nongovernmental applicants are required to submit, 
no later than the Federal due date for receipt of the application, the 
following information to the administrator of the State and local AIDS 
programs in the area(s) to be impacted by the proposal: (a) a copy of 
the face page of the application SF424); and, (b) a summary of the 
project PHSIS), not to exceed one page, which provides: (1) a 
description of the population to be served; (2) a summary of the 
services to be provided; and, (3) a description of the coordination 
planned with the appropriate State or local health agencies. Copies of 
the letters forwarding the PHSIS to these authorities must be contained 
in the application materials submitted to this program.

Certification Regarding Environmental Tobacco Smoke

    The Public Health Service strongly encourages all grant and 
contract recipients to provide a smoke-free workplace and to promote 
the non-use of all tobacco products. In addition, Public Law 103-227, 
the Pro-Children Act of 1994, prohibits smoking in certain facilities 
(or in some cases, any portion of a facility) in which regular or 
routine education, library, day care, health care or early childhood 
development services are provided to children.

Executive Order 12372

    The Special Projects of National Significance Grant Program has 
been determined to be a program subject to the provisions of Executive 
Order 12372, as implemented by 45 CFR 100. Executive Order 12372 allows 
States the option of setting up a system for reviewing applications 
from within their States for assistance under certain Federal programs. 
The application packages to be made available under this notice will 
contain a listing of States which have chosen to set up a review system 
and will provide a State Single Point of Contact (SPOC) in the State 
for the review. Applicants (other than federally recognized Indian 
tribes) should contact their SPOCs 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 of each affected 
state. The due date for State process recommendations is 60 days after 
the appropriate deadline dates. The Health Resources and Services 
Administration does not guarantee that it will accommodate or explain 
its responses to State process recommendations received after the due 
date. (See ``Intergovernmental Review of Federal Programs,'' Executive 
Order 12372, and CFR part 100, for a description of the review process 
and requirements.)

OMB Catalog of Federal Domestic Assistance

    Number for the Special Projects of National Significance is 93.928.

    Dated: September 1, 1998.
Claude Earl Fox,
Administrator.
[FR Doc. 98-23995 Filed 9-3-98; 8:45 am]
BILLING CODE 4160-15-P