[Federal Register Volume 64, Number 91 (Wednesday, May 12, 1999)]
[Notices]
[Pages 25776-25779]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-11981]



[[Page 25775]]

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Part VIII





Department of Health and Human Services





_______________________________________________________________________



Office of Public Health and Science; Announcement of Availability of 
Grants for Adolescent Family Life Demonstration Projects; Notice

  Federal Register / Vol. 64, No. 91 / Wednesday, May 12, 1999 / 
Notices  

[[Page 25776]]



DEPARTMENT OF HEALTH AND HUMAN SERVICES


Office of Public Health and Science; Announcement of Availability 
of Grants for Adolescent Family Life Demonstration Projects

AGENCY: Office of Adolescent Pregnancy Programs, Office of Population 
Affairs, OPHS, HHS.

ACTION: Notice.

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SUMMARY: The Office of Adolescent Pregnancy Programs (OAPP) requests 
applications for care, prevention and combination care/prevention 
grants under the Adolescent Family Life (AFL) Demonstration Projects 
Program. These Title XX grants are for community-based and community-
supported demonstration projects to: (1) find effective means of 
preventing pregnancy by encouraging adolescents to abstain from sexual 
activity through provision of age-appropriate education on sexually and 
decision-making skills, and (2) establish comprehensive and integrated 
approaches to the delivery of services to pregnant adolescents, 
adolescent parents and their children.
    The Title XX statute contains a provision limiting the amount of 
AFL funding which may be used for prevention projects to not more than 
one-third of the overall monies available for demonstration projects. 
In the Fiscal Year (FY) 1997 and 1998 appropriations for Title XX, as 
amended, Congress waived this limitation by enacting legislation which 
earmarked the majority of AFL demonstration funding for prevention 
grants, specifically abstinence education projects as defined in the 
Personal Responsibility and Work Opportunity Reconciliation Act of 
1996. Although the Senate Committee report accompanying the FY 1999 
appropriations act indicates that continued funding of more prevention 
projects is the intent of Congress, the FY 1999 appropriation for Title 
XX does not contain a similar provision waiving the statutory limit. In 
order to continue to fund a larger number of prevention projects than 
is allowable under the statute, the Department has asked Congress to 
amend the FY 1999 appropriation for Title XX to include a waiver of the 
``not more than one-third for prevention'' restriction. The Department 
expects that such a waiver will be enacted.
    Thus, new care, prevention and combination care/prevention projects 
under this announcement will only be funded if the amendment to the FY 
1999 appropriations act does not pass. If this amendment is enacted 
before the end of the fiscal year, funds will not be available to 
support new projects under this announcement. In the event FY 1999 
funds are not available for new care, prevention and combination care/
prevention projects, applications will be held for review and 
consideration in the following fiscal year, although the availability 
of funding in FY 2000 is uncertain.
    To ensure that there are adequate applications which could be 
funded in the event the amendment is enacted, the Department is also 
publishing a separate notice in the Federal Register announcing the 
availability of funds for prevention demonstration projects. Such 
applications would be considered for funding in the event the amendment 
described above is enacted.
    If the amendment to the FY 1999 appropriation for Title XX is not 
enacted, funds will be available for approximately 40 projects (25 care 
projects and 15 prevention projects), which may be located in any 
State, the District of Columbia, the territories of Puerto Rico, the 
U.S. Virgin Islands, Guam, American Samoa, Commonwealth of the Northern 
Mariana Islands, Republic of Palau, Republic of the Marshall Islands 
and the Federated States of Micronesia.

DATES: The closing date for this grant announcement is June 28, 1999. 
Applications will be considered as meeting the deadline if they are 
postmarked on or before the closing date. A legibly dated receipt from 
a commercial carrier or U.S. Postal Service will be accepted in lieu of 
a postmark. Private metered postmarks will not be accepted as proof of 
timely mailing. All hand delivered applications must be received 
between the hours of 8:30 a.m. and 5:00 p.m. on or before the above 
closing date. Applications which do not meet the deadline will be 
considered late applications and will be returned to the applicant. 
Applications will not be accepted by fax or e-mail. The submission 
deadline will not be extended.

ADDRESSES: Application kits consisting of the appropriate forms, a copy 
of the Title XX legislation, and guidance on the preparation of the 
application may be downloaded from the following Internet address: 
www.hhs.gov/progorg/opa/titlexx/oapp.html. If you do not have access to 
the Internet, you may obtain a kit from the Grants Management Office, 
Office of Population Affairs, 4350 East-West Highway, Suite 200, 
Bethesda, MD 20814. Written requests for application kits may be faxed 
to (301) 594-5981. All completed applications must be submitted to the 
Grants Management Office at the above mailing address. In preparing the 
application, it is important to follow ALL instructions contained in 
the application kit.

FOR FURTHER INFORMATION CONTACT: The OAPP Program Office at (301) 594-
4004. Staff is available to answer questions and provide limited 
technical assistance in the preparation of grant applications.

SUPPLEMENTARY INFORMATION: Title XX of the Public Health Service Act, 
42 U.S.C. 300z. et seq., authorizes the Secretary of Health and Human 
Services to award grants for demonstration projects to provide services 
to pregnant and nonpregnant adolescents, adolescent parents and their 
families. (Catalog of Federal Domestic Assistance Number 93.995) Title 
XX authorizes grants for three types of demonstration projects: (1) 
projects which provide ``care services'' only (i.e., services for the 
provisions of care to pregnant adolescents, adolescent parents and 
their families); (2) projects which provide ``prevention services'' 
only (i.e., services to prevent adolescent sexual relations); and (3) 
projects which provide a combination of care and prevention services.
    Under this program announcement, OAPP intends to make available 
approximately $12 million to support an estimated 40 new demonstration 
projects (25 care projects and 15 prevention projects). An applicant 
may submit a proposal for a local care, prevention or combination care/
prevention project. The awards for care projects will range fro 
$250,000 to $350,000. The awards for prevention projects will range 
from $150,000 to $250,000. Funding for combination care/prevention 
projects may be higher if in proportion to the effort proposed.
    Grants may be approved for project periods of up to five years. 
Grants are funded in annual increments (budget periods). Funding for 
all approved budget periods beyond the first year of the grant is 
contingent upon the availability of funds, satisfactory progress of the 
project, and adequate stewardship of Federal funds. A grant award may 
not exceed 70 percent of the total costs of the project for the first 
and second years, 60 percent of the total costs for the third year, 50 
percent for the fourth year and 40 percent for the fifty year. The non-
Federal share of the project costs may be provided in cash expenditures 
or fairly evaluated in-kind contributions, including facilities, 
equipment and services.
    We encourage application from experienced organizations which are 
currently operating programs and which

[[Page 25777]]

have the capability of expanding and enhancing these services to serve 
significant numbers of adolescents according to the guidelines 
specified in this announcement.
    The specific services which may be funded under Title XX are listed 
below under Care Programs and Prevention Programs. Applicants who 
propose to provide a Combination of Care and Prevention Services 
Program must meet the requirements for each type of program.
    The following application requirements contain information 
collections subject to OMB approval under the Paperwork Reduction Act 
of 1995 (Pub. L. 104-13). These information collections have been 
approved by OMB under control number 0937-0189.

Eligible Applicants

    Any public or private nonprofit organization or agency is eligible 
to apply for a grant. Grants are awarded only to those organizations or 
agencies which are determined to demonstrate the capability of 
providing the proposed services and meet the statutory requirements.

Care Programs

    Under this announcement, funds are available for local care 
demonstrations only. The project site must be identified in the 
application rather than selected after the grant is awarded.
    Under the statute the purpose of care programs is to establish 
innovative, comprehensive, and integrated approaches to the delivery of 
care services for pregnant adolescents and adolescent parents under 19 
years of age at program entry, with primary emphasis on unmarried 
adolescents who are 17 years old or younger and for their families. 
This includes young fathers and their families.
    The OAPP encourages the submission of care applications which 
propose to do the following: (1) Add care services to supplement 
existing adolescent health services in school, hospital or other 
community settings, (2) provide care services to minority or other 
disadvantaged population, (3) continue services to clients after the 
delivery of the baby to enable them to acquire good parenting skills 
and to ensure that their children are developing normally physically, 
intellectually and emotionally, (4) stress self-sufficiency skills, 
such as school completion (in mainstream or alternative schools and GED 
programs) and/or job training preparation and placement, and (5) 
involve males and promote male responsibility. Applicants should base 
their approaches upon an assessment of existing programs and, where 
appropriate, upon efforts to establish better coordination, integration 
and linkages among such existing programs.
    Applicants for care projects are required to provide, either 
directly or by referral, the following 10 core services:
    (1) Pregnancy testing and maternity counseling;
    (2) Adoption counseling and referral services which present 
adoption as an option for pregnant adolescents, including referral to 
licensed adoption agencies in the community if the eligible grant 
recipient is not a licensed adoption agency;
    (3) Primary and preventive health services, including prenatal and 
postnatal care;
    (4) Nutrition information and counseling;
    (5) Referral for screening and treatment of STDs;
    (6) Referral to appropriate pediatric care;
    (7) Educational services relating to family life problems 
associated with adolescent premarital sexual relations including:
    (a) Information about adoption,
    (b) Education on the responsibilities of sexuality and parenting.
    (c) The development of material to support the role of parents as 
the providers of sex education, and
    (d) Assistance to parents, schools, youth agencies and health 
providers to educate adolescents and preadolescents concerning self-
discipline and responsibility in human sexuality;
    (8) Appropriate educational and vocational services;
    (9) Mental health services and referral to mental health services 
and to other appropriate physical health services; and
    (10) Counseling and referral for family planning services.

    Note: Funds provided under Title XX may not be used for the 
provision of family planning services other than counseling and 
referral services unless appropriate family planning services are 
not otherwise available in the community. In accordance with sec. 
3006(a)(17) of Title XX (42 U.S.C. 300z-5(a)(17)), applicants must 
make maximum use of services available under the Title X Family 
Planning Program in providing this required core service.

    In addition to the 10 required core services listed above, 
applicants for care projects may provide any of the following 
supplemental services:
    (1) Referral to licensed residential care or maternity home 
services;
    (2) Child care sufficient to enable the adolescent parent to 
continue education or to enter into employment;
    (3) Consumer education and homemaking;
    (4) Counseling for the immediate and extended family members of the 
eligible person;
    (5) Transportation; and
    (6) Outreach services to families of adolescents to discourage 
sexual relations among unemancipated minors.

Prevention Programs

    Under this announcement, funds are available for local prevention 
projects only. The project site must be identified in the application 
rather than selected after the grant is awarded.
    The primary purpose of prevention programs is to find effective 
means of reaching adolescents, both male and female, before they become 
sexually active to encourage them to abstain from sexual activity. 
There is general agreement that early initiation of sexual activity 
brings not only the risk of unintended pregnancy but also substantial 
health risks to adolescents, primarily infection from sexually 
transmitted diseases (STDs), including HIV. Accordingly, applicants 
must provide services that help pre-adolescents and young adolescents 
acquire knowledge and skills that will instill healthy attitudes and 
encourage and support the postponement of early sexual activity. Any 
information provided for adolescents who may be or become sexually 
active, which relates to reducing the risk of unintended pregnancy and 
disease, must be medically accurate and must be presented within the 
context that abstinence is the best choice and is what the project 
recommends.
    Under this announcement, applicants may propose to develop and test 
new and/or innovative approaches aimed at promoting and fostering 
abstinence among adolescents. These approaches may consist of a variety 
of activities such as health, social, cultural, educational, economic 
and recreational activities, or combinations of all of these. 
Applicants may also propose to develop and test new prevention 
curricula and materials, update existing curricula, use existing 
educational materials/curricula, or use any combination of these 
materials, to implement their prevention demonstration projects. 
However, all materials and activities must be within the scope of the 
Title XX services listed below.
    OAPP encourages the submission of prevention applications which 
propose to do the following: (1) Add prevention services to supplement 
existing adolescent health education programs or health service 
programs in school or

[[Page 25778]]

other community settings, (2) provide prevention services to minority 
or other disadvantaged populations, (3) include medically accurate 
information on sexuality, contraception, sexually transmitted diseases 
(STDs) and HIV/AIDS, (4) offer educational services to parents to 
assist them in communicating with their children about sexuality, 
contraception, STDs and HIV/AIDS, and (5) involve males and promote 
male responsibility.
    Under the statutory requirements of Title XX, applicants for 
prevention programs are not required to provide any specific array of 
services; a proposal may include any one or more of the following 
services as appropriate:
    (1) Educational services relating to family life and problems 
associated with adolescent premarital sexual relations including:
    (a) Information about adoption,
    (b) Education on the responsibilities of sexuality and parenting,
    (c) The development of material to support the role of parents as 
the providers of sex education, and
    (d) Assistance to parents, schools, youth agencies and health 
providers to educate adolescents and preadolescents concerning self-
discipline and responsibility in human sexuality;
    (2) Appropriate educational and vocational services;
    (3) Counseling for the immediate and extended family members of the 
eligible person:
    (4) Transportation;
    (5) Outreach services to families of adolescents to discourage 
sexual relations among unemancipated minors;
    (6) Referral for screening and treatment of STDs;
    (7) Pregnancy testing and maternity counseling; and
    (8) Nutrition information and counseling.

Combination Care and Prevention Services Programs

    Applicants proposing to provide both care and prevention services 
must meet the requirements for both categories as described above. They 
must also propose to make a substantial effort in each of the two areas 
and indicate clearly in the application and budget the proportion of 
effort to be expanded in each component.
    It should be noted that, in all Title XX programs, including care, 
prevention and combination care/prevention programs, grantees may not 
teach or promote religion in their AFL projects. Each grant project 
must be accessible to the public generally, not just to those of a 
particular religious affiliation. All programming activities and 
program curriculum materials must contain medically accurate 
information, and must remain neutral on abortion. Upon approval for 
funding, all curricula and related educational materials must be 
submitted to OAPP for review and approval prior to use in AFL project.
    In addition, Under sec. 2011(a) of the Act, AFL projects may not 
provide abortions or abortion counseling or referral either directly or 
through sub-contract and may not advocate, promote or encourage 
abortion. However, if both the adolescent and her parents request 
abortion counseling, a project may provide referral for such 
counseling.

Evaluation

    Section 2006(b)(1) of Title XX requires each grantee to expend at 
least one percent but not more than five percent of the Federal funds 
received under Title XX on evaluation of the project. As this is a 
demonstration program, all applications are required to have an 
evaluation component of high quality consistent with the scope of the 
proposed project and the funding level. All project evaluations should 
monitor program processes to determine whether the program has been 
carried out as planned and measure the program's outcomes. Waivers of 
the five percent limit on evaluation may be granted in cases where a 
more rigorous or comprehensive evaluation effort is proposed (see sec. 
2006(b)(1)).
    Section 2006(b)(2) of Title XX requires that the evaluations 
required by sec. 2006(b)(1) be conducted by an organization or entity 
independent of the grantee providing services. To assist in conducting 
the evaluations, each grantee shall develop a working relationship with 
a college or university located in the grantee's state which will 
provide or assist in providing monitoring and evaluation of services. 
The OAPP strongly recommends extensive collaboration between the 
applicant organization and the proposed evaluator in the development of 
the intervention, development of the evaluation hypothesis(es), 
identification of the variables to be measured and a timetable for 
initiation of the intervention, baseline measurement, and ongoing 
evaluation data collection and analysis. In the preparation of the 
application for Title XX funds, OAPP encourages applicants to work with 
the proposed evaluator to ensure that the evaluation plan is detailed 
and consistent with the project's proposed goals and objectives.

Application Requirements

    Applications must be submitted on the forms supplied (PHS 516 1-1, 
Revised 5/96) and in the manner prescribed in the application kits 
provided by the OAPP. Applicants are required to submit an application 
signed by an individual authorized to act for the applicant agency or 
organization and to assume for the organization the obligations imposed 
by the terms and conditions of the grant award.
    Applicants must be familier with Title XX in its entirety to ensure 
that they have complied with all applicable requirements. A copy of the 
legislation is included in the application kit.

Additional Requirements

    Applicants for grants must also meet both of the following 
requirements (each year):
    (1) Requirements for Review of an Application by the Governor. 
Section 2006(e) of Title XX requires that each applicant shall provide 
the Governor of the State in which the applicant is located a copy of 
each application submitted to OAPP for a grant for a demonstration 
project for services under this Title. The Governor has 60 days from 
the receipt date in which to provide comments to the applicant.
    An applicant may comply with this requirement by submitting a copy 
of the application to the Governor of the State in which the appplicant 
is located at the same time the application is submitted to OAPP. To 
inform the Governor's office of the reason for the submission, a copy 
of this notice should be attached to the application.
    (2) Requirements for Review of an Application Pursuant to Executive 
Order 12372 (SPOC Requirements). Applications under this announcement 
are subject to the review requirements of E.O. 12372, 
``Intergovernmental Review of Federal Programs,'' as implemented by 45 
CFR part 100, ``Intergovernmental Review of Department of Health and 
Human Services Programs and Activities.'' E.O. 12372 sets up a system 
for state and local government review of proposed Federal assistance 
applications. As soon as possible, the applicant (other than Federally-
recognized Indian tribal governments) should contact the State Single 
Point of Contact (SPOC) for each state in the area to be served. The 
application kit contains the currently available listing of the SPOCs 
which have elected to be informed of the submission of applications. 
For those states not represented on the listing, further inquiries 
should be made by the applicant regarding submission to the relevant 
SPOC. The SPOC's comment(s) should be forwarded to the Grants 
Management Office, Office of Population Affairs, 4350 East-West

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Highway, Suite 200, Bethesda, MD 20814. The SPOC has 60 days from the 
closing date of this announcement to submit any comments.

Application Consideration and Assessment

    Applications which are judged to be late or which do not conform to 
the reqirements of this program announcement will not be accepted for 
review. Applicants will be so notified, and the applications will be 
returned. All other applications will be reviewed by a multi-
disciplinary panel of independent reviewers and assessed according to 
the following criteria:
    (1) The capacity of the proposed applicant organization to provide 
rapid and effective use of resources needed to conduct the project, 
collect data and evaluate it. This includes personnel, time and 
facilities. (30 points)
    (2) The applicant's rationale for use of the proposed approach and 
its worth for testing and/or replication based upon its previous 
demonstration, review of the literature and/or evaluation findings. (20 
points)
    (3) The applicant's presentation of an appropriate project design, 
consistent with the requirements of Title XX, including a clear 
statement of goals and objectives, reasonable methods for achieving the 
objectives, a reasonable workplan and timetable and a clear statement 
of results or benefits expected. (30 points)
    (4) The applicant's presentation of a detailed evaluation plan, 
indicating an understanding of program evaluation methods and 
reflecting a practical, technically sound approach to assessing the 
project's achievement of program objectives. (20 points)
    Final grant award decisions will be made by the Deputy Assistant 
Secretary for Population Affairs. In making these decisions, the Deputy 
Assistant Secretary for Population Affairs will take into account the 
extent to which grants recommended for approval will provide an 
appropriate geographic distribution of resources, the priorities in 
sec. 2005(a), and the other factors in sec. 2005, including 
consideration of:
    (1) The applicant's capacity to administer funds responsibly;
    (2) The incidence of adolescent pregnancy and the availability of 
services in the geographic area to be served;
    (3) The population to be served;
    (4) The community commitment to and involvement in planning and 
implementation of the demonstration project;
    (5) The organizational model(s) for delivery of service;
    (6) The usefulness for policymakers and service providers of the 
proposed project and its potential for complementing existing 
adolescent health models;
    (7) The reasonableness of the estimated cost to the government 
considering the anticipated results.
    OAPP does not release information about individual applications 
during the review process until final funding decisions have been made. 
When these decisions have been made, applicants will be notified by 
letter of the outcome of their applications. The official document 
notifying an applicant that an application has been approved for 
funding is the Notice of Grant Award, which specifies to the grantee 
the amount of money awarded, the purpose of the grant, the terms and 
conditions of the grant award, and the amount of funding to be 
contributed by the grantee to project costs.

    Dated: April 26, 1999.
Denese O. Shervington,
Deputy Assistant Secretary for Population Affairs.
[FR Doc. 99-11981 Filed 5-11-99; 8:45 am]
BILLING CODE 4160-17-M