[Federal Register Volume 64, Number 95 (Tuesday, May 18, 1999)]
[Notices]
[Pages 26971-26975]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-12440]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Program Announcement 99080]
Integration of HIV and Other Prevention Services Training Into
Reproductive Health Settings; Notice of Availability of Funds
A. Purpose
The Centers for Disease Control and Prevention (CDC) announces the
availability of fiscal year (FY) 1999 funds for a cooperative agreement
program for the training of reproductive health service providers in
the integration of human immunodeficiency virus (HIV) and other
prevention services into ongoing reproductive health services. This
program will support national efforts to develop improved training
strategies for reproductive health service providers to meet the
challenge of delivering integrated reproductive health and HIV
prevention services in reproductive health settings. This program
addresses the ``Healthy People 2000'' priority areas of Family
Planning, HIV Infection, and Tobacco.
Competitive cooperative agreements are announced for:
Core components: The focus will be on HIV prevention counseling and
the integration of HIV prevention services into reproductive health
services.
Optional components: To provide training and other integrated
services technical assistance to reproductive health service providers
in: (1) reproductive health and prevention services for underserved
women (specifically to incarcerated, homeless, and substance-abusing
women); (2) client satisfaction and the importance and impact it has on
the provision of integrated reproductive health and prevention
services; (3) teen pregnancy prevention efforts; and (4) efforts to
reduce smoking during pregnancy.
CDC will establish cooperative agreements with one Regional
Training Center (RTC) in each of the 10 Department of Health and Human
Services (DHHS) Regional Offices. The RTCs will develop, conduct, and
evaluate effective, consistent, and science-based training and other
services integration interventions to reproductive health service
providers, including but not limited to Title X family planning
clinics, Community-Based Organizations (CBOs), Managed Care
Organizations (MCOs), and State and local health departments.
Throughout this document, the term reproductive health service
providers will encompass this spectrum of providers; the term training
encompasses a wide spectrum of activities that may include traditional
classroom training, one-on-one consultation, observations with
feedback, distance-based learning (i.e., video and audioconferencing,
computer-based learning systems, remote video instruction, self-
instructional text modules, and train-the-trainer technology), etc.
B. Eligible Applicants
Assistance will be provided to non-profit organizations that are
primarily training organizations. In addition, applicants must:
1. Demonstrate experience in offering training courses in the
integration of HIV prevention with family planning for Title X grantees
(as evidenced by (a) marketing materials promoting such training events
and (b) a list of such trainings provided in the last year, including
the name and location of training event).
2. Be located in the DHHS region in which training is to be
provided (as evidenced by accompanying letterhead and contact
information on all application forms).
3. Offer training to participants in all States within said DHHS
region (as evidenced by marketing materials promoting training events
throughout the region).
For an overview of previous CDC involvement in HIV prevention
efforts in family planning settings, see Appendix I.
Note: Public Law 104-65 states that an organization described in
section 501(c)(4) of the Internal Revenue Code of 1986 that engages
in lobbying activities is not eligible to receive Federal funds
constituting an award, grant, cooperative agreement, contract, loan
or any other form.
C. Availability of Funds
Approximately $1.36 million is available in FY 1999 to fund
approximately 10 awards. Only the 10 applicants funded for the Core
Activity will be eligible for funding under the Optional Activity.
1. Approximately $560,000 is available to fund one Regional
Training Center in each of the 10 DHHS Regional Offices for Core
Activities, with the average award being approximately $56,000, which
range from $40,000 to $80,000.
2. Approximately $800,000 is available to fund Optional Activities.
Separate applications must be submitted for each Optional Activity. The
Optional Activities are:
(a) Underserved Populations. Approximately $150,000 is available to
fund approximately three awards. The average award will be
approximately $50,000, which range from $30,000 to $70,000.
(b) Client Satisfaction. Approximately $150,000 is available to
fund approximately three awards. The average award will be
approximately $50,000, which range from $30,000 to $70,000.
(c) Teen Pregnancy Prevention. Approximately $250,000 is available
to fund approximately four awards. The average award will be
approximately $62,500, which range from $50,000 to $80,000.
(d) Prenatal Smoking Cessation. Approximately $250,000 is available
to fund approximately four awards. The average award will be
approximately $62,500, which range from $50,000 to $80,000.
All applicants must apply for the Core Activity component and can
address one or both of the Core Activity components: HIV Prevention
Counseling and HIV Services Integration. Applicants are strongly
encouraged to apply for one or more of the four Optional Activity
components.
It is expected that the awards will begin on or about September 30,
1999, and will be made for a 12-month budget period within a project
period of up to five years. Funding estimates may change.
Continuation awards within the approved project period will be made
on the basis of satisfactory progress as evidenced by required reports
and the availability of funds.
Funding Preference
Funding preference may be given to applicants that are also funded
as RTCs by Office of Population Affairs.
D. Program Requirements
In conducting activities to achieve the purpose of this program,
the recipient will be responsible for the activities under 1.,
(Recipient Activities), and CDC will be responsible for the activities
listed under 2., (CDC Activities).
1. Recipient Activities
(a) Design a training intervention or carry out an existing
training intervention to address the prevention needs of reproductive
health service providers.
(b) Design and conduct an impact evaluation of the training
intervention to assess the impact at the direct service level.
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(c) Develop and carry out a program plan and training objectives:
(1) Identify the organization(s) to benefit from the intervention.
In making the selection, consider annual training needs assessments,
the level and willingness to participate and commit to the intervention
on the part of a reproductive health services provider, and the level
of available funding. Also consider other types of information that
will assist in the development of program and training objectives, such
as: types of health care providers and clinics; population served;
geographic locations; substantive topics relevant to recent prevention
or integrated reproductive health research findings; HIV/AIDS
epidemiologic, demographic and behavioral data; sexually transmitted
disease (STD) rates, unplanned pregnancy rates; teenage pregnancy or
birthrates; substance abuse data; HIV prevention research findings;
prenatal smoking cessation efforts; and level of other sources of
prevention training in each region.
(2) Develop overall goals for the training intervention. Consider
annual training needs assessments, previous experience in developing
and conducting prevention or integrated reproductive health
interventions, the specific needs of the selected reproductive health
services provider, and the guidance of the Core Activities and Optional
Activities as described in Section E., Application Content.
(3) Develop specific, time-phased, and measurable program
objectives.
(4) Develop training objectives. These should be linked to the
training needs assessment and relevant prevention or integrated
reproductive health research findings, and should include behavioral,
knowledge, and skills-based learning objectives. Each objective should
be linked to an evaluation criteria.
(5) Develop training activities and programs to achieve objectives.
Training can include workshops, in-service programs, conference co-
sponsorship, short-term training institutes, and distance-based
learning activities.
(d) Make available any training materials developed for prevention
or integrated reproductive health training to other RTCs.
(e) In collaboration with the other RTCs, develop a strategy for
sharing information related to the training intervention with other
RTCs. A recommended training summary database is located in Appendix
II.
2. CDC Activities
(a) Provide scientific consultation for development of training
activities.
(b) Assist in developing evaluation strategies as needed.
(c) Coordinate dissemination of relevant findings from prevention
or integrated reproductive health interventions to other training
centers in a timely manner.
(d) Coordinate communication with other CDC programs as needed.
(e) Coordinate dissemination of evaluation findings from the
prevention or integrated reproductive health interventions.
E. Application Content
Each applicant must apply for the Core Activity. Applications for
the Core Activity can address one, or both, of the Core Activity
components: HIV Prevention Counseling and HIV Service Integration. The
application should clearly state which Core Activity components are
being applied for. In this program announcement, the term intervention
will refer to HIV prevention training or HIV services integration.
Core Activities
1. HIV Prevention Counseling. The design, delivery, evaluation, and
dissemination of prevention counseling training for reproductive health
service providers based on the translation of effective components of
behavioral science. (See Appendix III for background information.)
2. HIV Service Integration. The design, delivery, and evaluation of
management assessments, training, and other health management
interventions for reproductive health service providers seeking to
integrate STD/HIV, other prevention services, and family planning
services into their service operations. (See Appendix IV for background
information.)
Each applicant is encouraged to apply for one or more of the
Optional Activity components. Only the applicants funded for Core
Activity components are eligible to receive funding for Optional
Activities.
Optional Activities
1. Underserved Populations. Activities to address the HIV and other
prevention training needs of reproductive health service providers
working with underserved populations. In particular, the HIV and other
prevention training needs of reproductive health service providers
working with: (1) substance-abusing women, (2) homeless women, and (3)
incarcerated women. (See Appendix V for background information.)
2. Client Satisfaction. Activities designed to assess and
demonstrate the role of client satisfaction in planning and evaluating
services offered by reproductive health programs. Applicants may
consider a broad range of client satisfaction assessment methodologies
addressing services management issues such as communications, quality
of health services care, organization of health care delivery, patient
access, physical plant infrastructure, and health care staff on-the-job
satisfaction. (See Appendix VI for background information.)
3. Teen Pregnancy Prevention. Activities to disseminate information
on teen pregnancy trends and issues and on best practices regarding
teen pregnancy prevention; design training for reproductive health
service providers on best practices regarding teen pregnancy
prevention; explore ways to integrate specific teen pregnancy
prevention interventions and comprehensive prevention strategies into
ongoing community and health system-based programs that serve youth;
and develop and carry out approaches to evaluate the effectiveness of
the training and service integration strategies on system integration
and service delivery. (See Appendix VII for background information.)
4. Prenatal Smoking Cessation. Activities to disseminate
information on best practices in prenatal smoking cessation (PSC);
design training for reproductive health services providers in carrying
out best practice intervention(s) for PSC; explore ways to integrate a
specified smoking during pregnancy intervention into ongoing
reproductive health services, especially family planning and prenatal
care services; and develop and carry out approaches to evaluate the
effectiveness of the training and service integration strategies on
system integration and service delivery. (See Appendix VIII for
background information.)
Use the information in the Program Requirements, Other
Requirements, and Evaluation Criteria sections to develop the
application content. Each of the proposals for the Core and Optional
Activities within your application will be evaluated independently on
the criteria listed below; it is important to follow the criteria in
laying out your program plan.
The narrative for the proposals should be no more than 15 double-
spaced pages, printed on one side, with one-inch margins, and unreduced
font, excluding appendixes and budgets. Applicants are to submit
separate narratives and budgets for each Core Activity and each
Optional Activity and each application must follow the order and
structure below.
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1. Background
(a) Describe the applicant's history and current health-related
activities or projects.
(b) Describe the current status of the relevant training program
and specific experiences as applicable to each proposed activity.
Include a summary of prevention or integrated reproductive health
training and other related services integration interventions conducted
in the past year, including the name and location of the training
events, the types of health professionals trained, any demographic data
available about the trainees, the types of organizations trained,
evaluation results, curricula and other training materials developed,
and level and type of collaboration with other organizations in
developing and delivering training.
2. Needs Assessment
(a) Include a copy of the latest related regional training needs
assessment conducted by your organiztion, describe the process involved
in conducting the needs assessment, and explain how the results will be
used to plan, develop, or modify training activities and curricula for
the project period.
(b) Describe the relevant problem (e.g., HIV, underserved women,
teen pregnancy, pregnant women who smoke) among women in the region
including the documented number of cases, and other data indicating
behavioral risks for women such as STD rates, tobacco use, substance
abuse data, rates of incarceration, information on homeless women, teen
pregnancy, and unplanned pregnancy rates. Applicant should indicate the
source(s) of data provided.
(c) Identify and describe the reproductive health service
provider(s) for which the intervention is being proposed and why.
Describe the demographics of the communities these agencies serve and a
description of the services they provide. Indicate the source(s) of
data provided. Include letters of support and intent to collaborate
from the directors of the identified agencies.
(d) Describe the professional backgrounds and organizational
affiliations of staff for which the intervention is being proposed and
why. The applicant should describe the number of health care providers
potentially eligible for the intervention and the degree of access
these providers have to the populations at risk. Indicate the source(s)
of data provided.
(e) Describe any anticipated obstacles to providing the
intervention to the proposed organizations and personnel.
(f) Describe all current sources of funding for prevention or
integrated reproductive health services training.
3. Goals and Objectives
(a) Provide realistic overall goals and objectives for each
proposed activity. For the purposes of clarity and comparability, the
term goal is defined as the proposed long-range benefits of the program
for the selected population, defined in general terms. The goals should
relate to the results of the needs assessment and to relevant
prevention and integrated reproductive health services research.
(b) Provide specific, time-phased, and measurable objectives for
the intervention, and describe activities planned to meet each
objective. For the purposes of clarity and comparability, the term
objective is defined as the anticipated results or outcomes of a
program, representing changes in the knowledge, attitudes, and
behaviors of the program's clients, described in measurable terms and
indicating a specific period of time during which these results will be
achieved. Applicants should describe the time-phased objectives of the
program and the activities intended to support these objectives. For
each objective, note which of the goals it will support and how the
objective's achievement will contribute to meeting the goal; and
indicate how the applicant plans to measure its achievement.
(c) Provide long-term (five-year) program goals, including expected
impact of the intervention on staff's prevention or integrated
reproductive health knowledge, skills, and abilities and on service mix
and implementation.
4. Training Plan
(a) Clearly describe the training plan for each proposed activity.
(b) For year one, provide proposed training course schedules,
agendas, outlines, objectives for training, and estimated number of
staff that will receive training.
5. Evaluation Plan
(a) Identify primary stakeholders in the evaluation process. (See
Appendix IX for additional guidance related to evaluation.)
(b) Clearly identify the evaluation plan for each proposed
activity.
(c) Describe the methodology for developing and implementing an
evaluation plan and how the evaluation results will be used (what
purpose they will serve). The applicant's evaluation plan should
consist of two parts, as described below. For both parts, the applicant
should describe how data will be collected and analyzed. No less than
three percent of total cooperative agreement funds applied for must
support evaluation activities.
(1) The first part should include evaluation methods such as
trainee satisfaction with the training and pre-test and post-test
assessments of participants to determine staff skills and knowledge
attained. The effectiveness of training content and training
methodologies should also be evaluated to influence course format,
content, and curriculum design. These activities should be incorporated
as a routine part of the training activity.
(2) The second part should include a longer-term evaluation plan to
assess at least one of the following: trainee's on-the-job behavioral
skills change; change in trainee's workplace prevention or integrated
reproductive health operations; improvement in quality of client care;
and promotion and support for prevention or integrated reproductive
health within the applicant's jurisdiction.
6. Program Staff
(a) Provide resumes and job descriptions of existing and newly
proposed staff, identifying what each will provide, e.g., management
and supervision, planning, curricula and course design, curricula and
course delivery and evaluation, and staff support.
(b) Provide an organizational chart that identifies lines of
authority including who will have management authority over the
intervention.
7. Budget and Justification
Provide a detailed budget and line-item justification for all
operating expenses that are consistent with the proposed program
objectives and activities for each activity. Applicants should include:
(a) Any trainee travel costs that may be incurred.
(b) Cost for one annual trip for two staff persons to attend a
planning, training, and information sharing meeting in Atlanta, Georgia
(or another central location in the continental United States).
(c) A minimum of three percent of total budgeted funds to support
evaluation activities.
F. Submission and Deadline
Submit the original and two copies of application form PHS 5161-1
(OMB Number 9037-0189). Forms are in the application kit. On or before
July 6, 1999, submit the application to: Gladys Gissentanna, Grants
Management Specialist, Grants Management Branch,
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Procurement and Grants Office, Announcement 99080, Centers for Disease
Control and Prevention (CDC), 2920 Brandywine Road, Room 3000, Atlanta,
Georgia 30341-4146.
Deadline: Applications shall be considered as meeting the deadline
if they are either:
1. Received on or before the deadline date.
2. Sent on or before the deadline date and received prior to
submission to the review panel. (Applicants must request a legibly
dated United States Postal Service postmark or obtain a legibly dated
receipt from a commercial carrier or United States Postal Service.
Private metered postmarks shall not be acceptable as proof of timely
mailing.)
Late Applications: Applications that do not meet the criteria in
(1) or (2) above are considered late applications, will not be
considered, and will be returned to the applicant.
G. Evaluation Criteria (Total 100 Points)
Each application will be evaluated independently against the
criteria below by an independent review group appointed by CDC.
The Core Activity and each Optional Activity will be reviewed and
scored independently. The total possible score for each individual
activity is 100 points. Determination of the 10 RTCs will be made
according to the top score based on rank order of the Core Activity,
one award per DHHS Region. Funds for Optional Activities will only be
awarded to the 10 selected RTCs.
1. Background (5 Points)
The extent to which the applicant demonstrates a) the ability to
plan, develop, coordinate, deliver, and evaluate the proposed
intervention; b) history of providing training to Title X family
planning clinics; and c) history of providing region-wide training on
this topic.
2. Needs Assessment (15 Points)
For each activity, the extent to which a) regional needs are
considered in selecting proposed agencies and staff for intervention,
b) need for the intervention is demonstrated, c) proposed agencies and
staff identified for the intervention are relevant, appropriate, and
accessible, and d) relevant prevention or integrated reproductive
health research findings are incorporated into the needs assessment
process.
3. Goals and Objectives (20 Points)
For each activity, the extent to which (a) goals are realistic; (b)
objectives are realistic, time-phased, and measurable and are linked to
appropriate evaluation criteria; and (c) the goals and objectives
support the results of the needs assessment.
4. Training Plan (25 Points)
For each activity, the extent to which a) the process to identify
training priorities appears appropriate and likely to promote and
support the intervention, b) the training plan corresponds to
identified needs, a reasonable number of the eligible trainee
population is provided training, and c) assurance of training product
dissemination is provided.
5. Evaluation Plan (20 Points)
The extent to which (a) methodologies for development and
implementation of an evaluation plan are appropriate; (b) strategies
for measuring program effectiveness, obtaining data, reporting results,
and using the results for making programmatic decisions are feasible
and result in useful information; and (c) no less than three percent of
the funds requested support evaluation efforts.
6. Program Staff (15 Points)
The extent to which appropriate staff are identified (e.g.
instructional specialists, evaluators, project managers, trainers,
support staff, computer specialists, accountants) who have
responsibility and authority for training activities, including
expertise in various aspects of reproductive health, HIV education,
counseling and testing, services integration, and behavior change
counseling.
7. Budget and Justification (Not Scored)
The extent to which the applicant provides a detailed and clear
budget and justification that is consistent with the proposed program
objectives and activities.
H. Other Requirements
1. Technical Reporting Requirements
Provide CDC with an original and two copies of:
(a) Semiannual Progress Report no later than 30 days after the end
of the second and fourth quarters. The progress report must include:
(1) a comparison of actual accomplishments to the goals established for
the period; (2) the reasons for slippage if established goals were not
met; and (3) other pertinent information including, when appropriate,
analysis and explanation of unexpectedly high costs for performance.
(b) Financial Status Report (FSR) no later than 90 days after the
end of budget period.
(c) Final Financial Status Report and Performance Report no later
than 90 days after the end of the project period.
Send all reports to: Gladys Gissentanna, Grants Management
Specialist, Grants Management Branch, Procurement and Grants Office,
Announcement 99080, Centers for Disease Control and Prevention (CDC),
2920 Brandywine Road, Room 3000, Atlanta, Georgia 30341-4146.
2. Additional Requirements
The following additional requirements are applicable to this
program. For a complete description of each, see Attachment I in the
application kit.
AR-5 HIV Program Review Panel Requirements
AR-7 Executive Order 12372 Review
AR-8 Public Health System Reporting Requirements
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2000
AR-12 Lobbying Restrictions
AR-15 Proof of Non-profit Status
I. Authority and Catalog of Federal Domestic Assistance Number
This program is authorized under Sections 301(a) and 317(k)(2) [42
U.S.C. 241(a) and 247b(k)(2)] of the Public Health Service Act, as
amended.
J. Where To Obtain Additional Information
Please refer to Program Announcement 99080 when you request
information. For a complete program description, information on
application procedures, an application package, and business management
technical assistance, contact: Gladys Gissentanna, Grants Management
Specialist, Grants Management Branch, Procurement and Grants Office,
Announcement 99080, Centers for Disease Control and Prevention (CDC),
2920 Brandywine Road, Room 3000, Atlanta, Georgia 30341-4146,
Telephone: (770) 488-2753. E-mail address: [email protected]
Additional written information and application kits can also be
requested by calling 1-888-GRANTS4 (1-888-472-6874). You will be asked
to leave your name and address and will be asked to identify the
program announcement of interest.
See also the CDC Internet web site (www.cdc.gov) and the Program
and Grants Office web site for additional funding opportunities and
electronic versions of all necessary forms (www.cdc.gov/od/pgo/
forminfo.htm).
For program technical assistance, contact: Mary Kay Larson, Chief,
Services Management and Research Team, Program Services and
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Development Branch, Division of Reproductive Health, 4770 Buford
Highway, NE, Mail Stop K-22, Atlanta, GA 30341-3717, Tel: (770) 488-
5221, E-mail: [email protected].
Dated: May 12, 1999.
John L. Williams,
Director, Procurement and Grants Office, Centers for Disease Control
and Prevention (CDC).
[FR Doc. 99-12440 Filed 5-17-99; 8:45 am]
BILLING CODE 4163-18-P