[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