[Federal Register Volume 64, Number 97 (Thursday, May 20, 1999)]
[Notices]
[Pages 27564-27570]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-12694]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention and Health Resources and 
Services Administration
[Program Announcement 99099]


CDC/HRSA Cooperative Agreements for HIV/AIDS Intervention, 
Prevention, and Continuity of Care Demonstration Projects for 
Incarcerated Individuals Within Correctional Settings and the 
Community; Notice of Availability of Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) and the Health 
Resources and Services Administration (HRSA) announce the availability 
of fiscal year (FY) 1999 funds for a cooperative agreement program for 
HIV (Human Immunodeficiency Virus) Prevention, Intervention, and 
Continuity of Care Within Correctional Settings and the Community. This 
program addresses the ``Healthy People 2000'' priority areas of HIV 
Infection and Clinical Preventive Services. The purpose of the program 
is to support demonstration projects within correctional facilities and 
the community that develop models of comprehensive surveillance, 
prevention, and health care activities for HIV, Sexually Transmitted 
Diseases (STDs), Tuberculosis (TB), Substance Abuse and Hepatitis. It 
is targeted for persons in correctional settings that extend to the 
community upon their release. This includes jails, detention centers, 
prisons, and transitional halfway houses. The target population 
includes African Americans and other ethnic/racial minorities that are 
disproportionately affected by the HIV/AIDS epidemic and detained/
incarcerated in the criminal justice system, especially jails and 
juvenile detention facilities. Projects may develop collaborative 
arrangements between correctional settings and community-based health 
care and support service providers that address continuity of health 
care and provision of other ancillary and supportive services upon 
release that contribute to positive behavior change, and increase 
health care access, and improve health status. A background concept 
paper and descriptions of prevention, primary care, and continuity of 
services are included in the application kit.
    This initiative is co-funded under Special Projects of National 
Significance (SPNS) authority of the Ryan White CARE Act. SPNS grants 
advance knowledge and skills in the delivery of health and support 
services to under served populations diagnosed with HIV infection. SPNS 
is the research and development arm of the Ryan White CARE Act. 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.
    Projects should be innovative in creating a combination of 
services/activities (surveillance, medical and behavioral screening and 
assessment, prevention education and counseling, primary health care 
and referral linkages) and have the organizational capacity to work 
within correctional settings and to organize and maintain a network of 
these services for the individual within the larger community. Because 
jails and juvenile detention facilities most reflect the community, 
special prioritization should be given to working in these settings. It 
is desirable to have a multi-tiered focus (including jails, prisons, 
juvenile detention centers, and transitional halfway houses) on the 
provision of a variety of direct services, the ability to 
organizationally and structurally work within correctional and 
community-based systems of care, and the potential ability to implement 
long-term systemic change. Applicants should recognize that this 
demonstration is not designed and cannot be expected to provide support 
beyond the project period.

B. Eligible Applicants

    Assistance will be provided only to the following geographic areas: 
California, Connecticut, the District of Columbia, Florida, Georgia, 
Illinois, Maryland, Massachusetts, New Jersey, New York State, 
Pennsylvania, and Texas. These States are designated priority areas 
based on three criteria: (1) They represent 56.2 percent (635,483) of 
total prison population for 1997; (2) represent 74.7 percent (76,679) 
of all African American AIDS cases for 1997; and (3) represent 19,361 
or 82.7 percent of all HIV+ inmates in state prisons. These states also 
represent 26 of the 30 highly affected MSAs for African Americans.
    For states in which there is a CDC directly-funded city (these 
cities are New York, Chicago, Los Angeles, San Francisco, Houston and 
Philadelphia) the application must come from a coalition of the state 
and directly-funded city health department(s) (to ensure continuity of 
care, as most inmates come from and return to these larger metropolitan 
areas). Either the

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state or directly funded city health department (or its bona fide 
agent) may submit the application but only one application each from 
California, Illinois, New York, Pennsylvania and Texas may be 
submitted. Proof of a formal collaborative agreement between state and 
city is required in the application from these jurisdictions.
    For Connecticut, District of Columbia, Florida, Georgia, Maryland, 
Massachusetts and New Jersey, only the State health department or its 
bona agent may submit an application.

C. Availability of Funds

    Approximately $7,000,000 is available in FY 1999 to fund five to 
eight awards. It is expected that the average award will be $1,000,000 
ranging from $450,000 to $1,300,000, including direct and indirect 
costs. 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 three years. Funding estimates may change.
    Due to inequities between corrections-based care and community 
care, at least 40 percent of the funds provided under these awards must 
be directed to community-based prevention and primary health care and 
other ancillary service providers to support and develop models of 
linked networks of health services including HIV/AIDS, STDs, TB, 
hepatitis and substance abuse prevention and treatment during and after 
incarceration.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.

Direct Assistance

    You may request Federal personnel as direct assistance, in lieu of 
a portion of financial assistance.

Use of Funds

    These funds may not be used to supplant or duplicate existing 
funding. Activities should build upon the existing infrastructure of 
CDC-supported HIV Prevention Services providers and HRSA-supported Ryan 
White Comprehensive AIDS Resources Emergency (CARE) Act funded primary 
health care providers, or community health centers and other medical 
providers or services that treat individuals incarcerated in 
correctional facilities or who treat recently-released individuals. 
Activities should be coordinated with SAMHSA supported drug treatment 
and prevention programs. Recipients may contract with other 
organizations under these cooperative agreements, however, recipients 
must perform a substantial portion of the activities (including program 
management and operations and delivery of prevention services) for 
which funds are requested. Applications requesting funds to support 
only administrative and managerial functions will not be accepted. CARE 
Act funds are considered payor of last resort and cannot be used to 
supplant services supported within correctional systems.

Funding Preference

    In making awards, preference will be given to those projects that 
propose to improve access to prevention and primary health care and the 
health status of African Americans and other racial or ethnic 
minorities during incarceration and upon their release. Projects 
should: (1) document the burden of disease for this population; (2) 
increase access to HIV/AIDS primary health care and prevention 
services; (3) improve HIV transitional services between corrections and 
the community; and, (4) develop linked networks of HIV, STD, TB, and 
substance abuse health and social services for soon to be or recently 
released African Americans and other racial or ethnic minorities.
    Priority will be give to geographic distribution across the 
eligible areas and racial/ethnic groups consistent with HIV/AIDS 
morbidity. Public comments are not being solicited because time is 
insufficient for solicitation and review of comments before the funding 
date.

D. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under recipient 
activities, and CDC and HRSA will be responsible for activities under 
CDC and HRSA activities.
    1. Recipient Activities: For the target population of incarcerated 
or soon to be released/recently released incarcerated persons the 
recipient will:
    a. Use epidemiologic data, needs assessments, and prioritization of 
groups and interventions to design program activities (corrections and 
community-based) for African American and other disproportionately 
affected racial/ethnic minorities at high risk for HIV.
    b. Review and ensure consistency of proposed activities with 
applicable State and local comprehensive HIV Prevention and Ryan White 
CARE Act plans.
    c. Coordinate program activities with relevant national, regional, 
State, and local HIV prevention programs to prevent duplication of 
efforts.
    d. Monitor and evaluate all major program activities and services 
supported with funds under this cooperative agreement.
    e. Develop a proposal for obtaining additional resources to 
supplement the program conducted through this cooperative agreement and 
to enhance the likelihood of its continuation after the end of the 
project period.
    f. Conduct HIV counseling, testing and referral services and health 
education and risk reduction interventions for persons at high risk of 
becoming infected or transmitting HIV to others.
    g. Assist high risk clients in gaining access to HIV antibody 
counseling, testing, and referral for other needed services and primary 
care.
    h. Assist HIV positive persons in gaining access to appropriate HIV 
treatment and other early medical care, substance abuse prevention 
services, STD screening and treatment, reproductive and perinatal 
health, partner counseling, notification and referral services, psycho-
social support, mental health services, TB prevention and treatment, 
health education and risk reduction services, and other supportive 
services. High risk clients who test negative should be referred to 
appropriate health education and risk reduction services and other 
appropriate prevention and treatment services.
    i. Support a continuum of care between corrections and the 
community in which all the needs of individuals with HIV disease and 
their families are coordinated. A comprehensive continuum of care 
includes: primary health care (including treatment of HIV infection 
consistent with Public Health Service guidelines [i.e., treatment of 
HIV infection in the following areas: adults and adolescents, 
pediatrics, maternal health and reduction of perinatal HIV 
transmission, prophylaxis and treatment of opportunistic infections], 
access to drug therapies including opportunistic infections 
prophylaxis/treatment and combination antiretroviral therapies, 
substance abuse treatment, mental health, dental, and hospice 
services); supportive services that enable individuals to access and 
remain in primary care; and other health or supportive services that 
promote health and enhance quality of life.
    j. Ensure (at a minimum) that all primary health care is consistent 
with published United State Public Health Services treatment guidelines 
(See appendix).
    k. Coordinate and collaborate with departments of corrections 
(prisons, jails, detention and pre-release facilities), community 
planning groups,

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community-based organizations and entities or agencies involved in HIV 
prevention and care activities, especially those serving the target 
population.
    l. Participate in a formative evaluation with the CDC/HRSA Program 
Support and Evaluation Center (to be selected for this project) in 
monitoring and evaluating all major program activities and services 
supported with CDC/HRSA HIV prevention and care funds under this 
cooperative agreement.
    m. Actively collaborate with CDC/HRSA Program Support and 
Evaluation technical assistance providers/consultants to assure the 
definition of and measurement of appropriate project outcome measure. 
During the initial project year, recipients will meet with other 
recipients to develop a collaborative data collection plan and agree on 
data collection instruments.
    n. Work in collaboration with the HRSA/CDC Evaluation Center to 
produce a series of formative evaluations that describe the program 
components that are critical to health seeking behaviors among 
previously incarcerated individuals, the costs associated with program 
interventions in and outside correctional settings, and lessons 
learned. Projects will provide basic data analyses and the supporting 
databases in the required CDC/HRSA-format.
    2. CDC and HRSA Activities:
    a. Provide consultation and technical assistance in planning, 
implementing, and evaluating prevention, treatment, and care 
activities. CDC and HRSA will provide consultation and technical 
assistance both directly and indirectly through prevention and primary 
care partners such as health departments, community health centers, 
drug treatment programs, hospitals and other providers of primary care, 
drug assistance programs, national and regional African American and 
other ethnic/minority organizations, criminal justice and corrections 
agencies and organizations (American Corrections Association, National 
Commission on Correctional Health Care, National Institute of Justice, 
Federal Bureau Of Prisons), and other national organizations.
    b. Provide up-to-date scientific information on the risk factors 
for HIV infection, prevention measures, treatment protocols and program 
strategies for prevention, treatment, and prevention case management 
for HIV infection.
    c. Assist in the design and implementation of program evaluation 
activities.
    d. Assist recipients in collaborating with community planning 
groups, community health centers, community-based organizations, 
primary care and substance abuse programs, state and local correctional 
facilities, and other federally supported HIV/AIDS prevention and care 
recipients.
    e. Facilitate the transfer of successful interventions, models of 
care, community linkages, and ``lessons learned'' through convening 
meetings of recipients, workshops, conferences, newsletters, and 
communications with project officers.
    f. Facilitate exchange of program information and technical 
assistance between community organizations, health departments, primary 
care and Ryan White Care Providers, State and local criminal justice 
and corrections facilities and national and regional organizations.
    g. Conduct an overall evaluation of this cooperative agreement 
program. A CDC/HRSA Evaluation will provide program assistance and 
support for overall evaluation coordination and assistance, including 
data management and analysis, training of recipient staff in evaluation 
procedures and distribution of necessary materials to all projects (See 
application kit for outline of CDC/HRSA Evaluation and Program Support 
Center Activities).
    h. Compile and facilitate ``lessons learned'' from the project and 
facilitate the dissemination of ``lessons learned,'' successful 
prevention interventions, and program models to other organizations and 
CDC through peer to peer interactions, meetings, workshops, 
conferences, and communications with project officers.

E. Application Content

    You must document that this proposal is consistent with the 
Statewide Coordinated Statement of Need document from your area or 
provide a rationale for any discrepancies. Note: This initiative is 
supported, in part from funds provided under the Special Projects of 
National Significance Program of the Ryan White Comprehensive AIDS 
Resource Emergency Act. Section 2691 (f) indicates that the Secretary 
may not make a grant under this program ``unless the applicant submits 
evidence that the proposed program is consistent with the Statewide 
Coordinated Statement of Need, and the applicant agrees to participate 
in the ongoing revision process of such statement of need.''
    Your application should build upon the current HIV prevention and 
CARE community planning priorities for at risk and infected 
incarcerated individuals (pre-release and post-release). Proposed 
activities should include CARE-funded primary health care providers and 
community health centers and other medical providers of services that 
treat individuals incarcerated in correctional facilities or who treat 
individuals who were previously incarcerated.

    Note: Entities should already have some degree of activities in 
place that link correctional settings to community-based providers 
for specific services. These proposals should further develop the 
comprehensiveness of surveillance, prevention, and primary health 
care services provided. In addition, attention should be given to 
the organizational capacity required to provide for continuity in 
intervention, primary care, prevention, and psycho-social support 
and referral systems and linking correctional and community settings 
to improve the health seeking behaviors of populations and 
individuals most affected by HIV/AIDS.

    Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. The narrative should be no more than 35 double-spaced pages, 
printed on one side, with one inch margins, and unreduced 12 point font 
on 8\1/2\'' by 11'' paper, with at least 1'' margins, headings and 
footers, and printed on one side only. Number each page clearly and 
provide a complete index to the application and its appendices. Please 
begin each separate section of the application on a new page. Submit 
the original and each copy of the application set unstapled and 
unbound. Materials that should be part of the basic plan will not be 
accepted if placed in the appendices.
    In developing the application, follow the format and instructions 
below:

Format

1. Abstract
2. Assessment of Need and Justification for Proposed Activities
3. Long Term Goals
4. Program Plan
5. Evaluation Plan
6. Budget and Staffing Breakdown and Justification
7. Training and Technical Assistance Plan
8. Attachments

Instructions

    1. Abstract (not to exceed 2 pages): summarize your proposed 
program activities. Include the following:

[[Page 27567]]

    a. Brief summary of the need for the proposed activities;
    b. Long-term goals;
    c. Brief summary stating compliance with HIV Prevention and Ryan 
White CARE Act plans;
    d. Brief summary of proposed plan of operation, including the 
populations to be served, activities undertaken, and services to be 
provided;
    e. Brief summary of plans for collaboration and linkage development 
for continuity of care between corrections and the community; and
    f. Brief summary of year two and three activities.
    2. Assessment of Need and Justification for Proposed Activities 
(not to exceed 6 pages).
    a. Describe the incarcerated populations and the communities for 
which your proposed program will provide services;
    b. Describe the targeted correctional system, including the type of 
facility (jail, prison, detention, pre-release, halfway house, or after 
care program), the geographic area covered, the number of incarcerated 
individuals known or estimated to be HIV-infected and current role of 
the corrections systems in HIV prevention and care;
    c. Identify the need that will be addressed by your proposed 
program and describe how you assessed the need. Include epidemiologic 
and behavioral risk factor assessments or other data that were used to 
identify the need. Include a description of existing HIV prevention, 
risk-reduction, and primary care and psycho-social, and referral 
services provided by other organizations to address the needs of the 
target populations, continuity of care, and an analysis of the gap 
between the identified need and the resources currently available to 
address the needs (i.e., how will the proposed activities or program 
address important unmet HIV prevention and care needs and improve 
access to on-going HIV medical care and support services?);
    d. Describe the impact of the AIDS epidemic on the priority target 
population and their community and any specific environmental, social, 
cultural, or linguistic characteristics of the priority target 
populations which you have considered and addressed in developing your 
continuity of care strategies, such as:
    (1) HIV prevalence and incidence (if available), reported AIDS 
cases, and risk behaviors (sexual behaviors, substance use, etc.) in 
the target population.
    (2) HIV/AIDS-related baseline knowledge, attitudes, beliefs, and 
behaviors.
    (3) Patterns of substance use and rates of STDs and tuberculosis 
(TB), hepatitis.
    (4) Other relevant information. (Specify)
    e. Describe the specific behaviors, practices, and health outcomes 
that the proposed intervention or primary care/services are designed to 
promote and prevent (e.g., increases in correct and consistent condom 
use, knowledge of serological status, not sharing needles, and 
enrollment in drug treatment and other treatment and preventive 
programs);
    f. Describe how your proposed program complements the HIV 
prevention and care priorities identified in the applicable State or 
local comprehensive HIV prevention and Ryan White CARE Act plans; and
    g. Describe any specific barriers to the implementation of your 
proposed program and how you will overcome these barriers.
    3. Long-term Goals (not to exceed 1 page): Describe the broad HIV 
prevention and care goals that your program aims to achieve by the end 
of the project period (three years). Indicate which are prevention 
goals and which are primary care goals.
    4. Program Plan (not to exceed 12 pages): Use this section to 
describe your proposed program.
    a. Involvement of the target population: Describe the involvement 
of the incarcerated population, correctional systems, community-based 
care providers, and the community in planning, implementing, and 
evaluating activities and services throughout the project period;
    b. Program Objectives: Develop objectives that are specific, 
measurable, time-phased, realistic, related to the long-term goals and 
proposed activities, and if applicable, related to the prevention and 
care priorities outlined in the jurisdiction's comprehensive HIV 
prevention and Ryan White CARE Act plans. Describe the expected results 
of program activities on its priority populations. Describe any 
anticipated barriers to or facilitators for reaching these objectives;
    c. Plan of Operation:
    (1) Describe the specific activities to be conducted to accomplish 
the objectives.
    (2) Describe the services to be provided to accomplish the 
objectives.
    (3) Specify the approximate dates when activities will be 
accomplished and which staff will be responsible for conducting 
activities.
    (4) Describe the opportunity for volunteer involvement in your 
program. If volunteers will be involved, describe plans to recruit, 
train, place, and retain volunteers.
    (5) Describe how you will collaborate and develop a linked network 
of services with correctional facilities, local health departments, 
community health centers, primary care providers, pharmaceutical, 
substance abuse treatment, mental health, HIV and Ryan White planning 
groups, members of the target population, and other appropriate service 
groups or organizations in the development and implementation of your 
program.
    (6) Describe your mechanism for recruiting and including program 
participants.
    (7) Describe how you will promote your program in the community.
    (8) Describe the mechanism to assure client satisfaction.
    (9) Provide the following attachments: (a) a list of major 
community resources and health care providers to which referrals will 
be made, and any existing or proposed interagency agreements; (b) a 
plan for ongoing training to ensure that staff are knowledgeable about 
HIV/AIDS, STDs, hepatitis, TB, and other relevant health issues or 
risks (e.g., reproductive health, substance abuse) and prevention and 
care measures; (c) a plan to assess the performance of staff to ensure 
that they are providing information and services accurately and 
effectively; (d) a mechanism to initiate and verify referrals; and (e) 
protocols to guide and document training, activities, services, care, 
and referrals.
    (10) Describe how you will prioritize the program activities to 
place emphasis on populations within correctional settings and within 
communities that are disproportionately affected by HIV and AIDS.
    (11) Identify program staff responsible for conducting the proposed 
activities.
    d. Appropriateness of interventions and care:
    (1) Describe how the proposed priority interventions and care 
services are culturally tailored, sensitive to issues of sexual 
identity, developmentally- and educationally-appropriate, and 
linguistically-specific.
    (2) Describe the specific behaviors, practices, and health outcomes 
that the interventions and care services are designed to promote and 
prevent (e.g., medication compliance, enrollment in early intervention 
and care, increases in correct and consistent condom use, knowledge of 
serological status, not sharing needles, enrollment in drug treatment 
and other preventive programs).
    e. Coordination/Collaboration: Describe current, relevant 
collaborative efforts and service agreements within

[[Page 27568]]

the program's catchment area, especially with other HRSA, CDC, HUD, and 
SAMHSA funded service providers. Specify the organizations and agencies 
with which you will establish contractual agreements or qualified 
service organization agreements, and service linkages in the 
development and implementation of your project. If applicable attach 
copies of any agreements already in place in the Appendix.
    f. Time line: Provide a time line that indicates the approximate 
date by which activities will be accomplished.
    5. Program Evaluation Plan: CDC and HRSA project officers and the 
CDC/HRSA Program Support and Evaluation Center will collaborate with 
the recipient in the development of an evaluation plan after the award.
    Submission of a proposal signals the applicant's willingness to 
participate in multi-site evaluations with the other funded projects. 
Applicants must determine and document that their organization has the 
interest and can organize the human resources necessary (either from 
within the organization, through hiring an external evaluation 
consultant, or through a contract with a university-based researcher) 
to produce a thorough evaluation; and must include a plan assuring that 
their client population will participate in the data collection 
process. Applicants must also indicate how they will participate with 
the CDC and HRSA, the Evaluation Center, and other recipients in the 
dissemination of their findings for use by other HIV care providers.
    Project evaluations should measure project outcomes including 
health outcomes, where applicable. Evaluation questions should consider 
the following: organizational infrastructure development issues in 
integrating services; service demands over time; migration patterns of 
the population studied; enrollment rates; retention in program; client 
and provider satisfaction; client and provider participation in the 
program; client participation in treatment regimens; number of 
referrals and completed referrals; factors causing client dropout or 
loss to the project's continuum of care; numbers and types of services 
delivered; configurations of medical and prevention services that 
increase access; specific activities and related costs required to 
ensure use of needed medical and supportive services; issues of 
maintaining confidentiality over time in an integrated system; and 
barriers to obtaining medical records information in an integrated care 
system. It is anticipated that evaluations will include both 
quantitative and qualitative analysis.
    a. Evaluation Rationale: Document the questions that should be 
answered by the project's evaluation and propose specific indicators 
and measures that could be used to answer process and outcome questions 
for integrated service delivery systems or provider sites.
    b. Evaluation Plan: Outline some of the methods that might be used 
to gather data on the indicators listed above and how these methods 
might be implemented. Describe which staff or contractors will be 
responsible for the design, implementation, and completion for the 
proposed evaluation and of the resources available and needed within 
the organization to conduct internal evaluations, as well as being able 
to participate in multi-site evaluations.
    6. Budget/Staffing Breakdown and Justification:
    a. Detailed Budget: Provide a detailed budget for activities 
proposed, with accompanying justification of all operating expenses, 
that is consistent with the stated objectives and planned priority 
activities. CDC/HRSA may not fund all proposed activities. Be precise 
about the program purpose of each budget item and itemize calculations 
wherever appropriate. In the personnel section, specify the job title, 
annual salary/rate of pay, and percentage of time spent on this 
program.
    For contracts, name the contractor, if known; describe the services 
to be performed which justifies the use of a contractor; provide a 
breakdown of and justification for the estimated costs of the 
contracts; the period of performance; the method of selection; and 
method of monitoring the contract.
    b. Staffing Plan: Provide a job description for each position for 
this program that specifies job title, function, general duties, 
activities, and salary range. Include the level of effort and 
allocation of time for each project activity by staff positions. If the 
identity of any key personnel who will fill a position is known, her/
his name and resume should be attached. Experience and training related 
to the proposed project should be noted. If the identity of staff is 
not known, describe your recruitment plan. If volunteers are involved 
in the project, provide job descriptions.
    c. Direct Assistance: To request new direct-assistance assignees, 
include:
    (1) Number of assignees requested.
    (2) Description of the position and proposed duties.
    (3) Ability or inability to hire locally with financial assistance.
    (4) Justification for request.
    (5) Organizational chart and name of intended supervisor.
    (6) Opportunities for training, education, and work experiences for 
assignees.
    (7) Description of assignee's access to computer equipment for 
communication with CDC (e.g., personal computer at home, personal 
computer at workstation, shared computer at workstation on site, shared 
computer at a central office).
    7. Training and Technical Assistance Plan (not to exceed 2 pages): 
Describe areas in which you anticipate needing technical assistance in 
designing, implementing, and evaluating your program. Also, describe 
anticipated staff training needs related to the proposed program and 
how these needs will be met. This information will assist CDC/HRSA to 
better address your needs and help you to identify technical assistance 
and training providers.
    8. Attachments--Provide the following as attachments:
    a. An assurance that the funds being requested will not duplicate 
or supplant funds received from any other Federal or non-Federal 
source. CDC/HRSA awarded funds can be used to expand or enhance 
services supported with other Federal or non-Federal funds.

    Note: Materials submitted as attachments should be printed on 
one side of 8\1/2\ x 11 paper. Please do not attach bound materials 
such as booklets or pamphlets. Rather, submit copies of the 
materials printed on one side of 8\1/2\ x 11 paper. Bound materials 
may not be reviewed.

F. Submission and Deadline

    Submit the original and two copies of PHS 5161 (OMB Number 0937-
0189). Forms are in the application kit.
    On or before July 16, 1999, submit the application to: Ron Van 
Duyne, Grants Management Officer, Grants Management Branch, Procurement 
and Grants Office, Attn: Announcement 99099, Centers for Disease 
Control and Prevention, 2920 Brandywine Street, Room 3000, Mailstop E-
15, Atlanta, Georgia 30341-4146.
    Deadline: Applications shall be considered as meeting the deadline 
if they are either received on or before the deadline date or sent on 
or before the deadline date and received in time for submission to the 
independent review group. (Applicants must request a legibly dated U.S. 
Postal Service postmark or obtain a legibly dated receipt from a 
commercial carrier or U.S. Postal Service. Private metered postmarks 
shall not be acceptable as proof of timely mailing.) Applications that 
do not meet these criteria will not

[[Page 27569]]

be considered and will be returned to the applicant.

G. Application Evaluation Criteria

    Each application will be evaluated individually against the 
following criteria by an independent review group appointed by CDC.
    1. Assessment of Need and Justification for the Proposed Activities 
(20 points).
    The extent to which the applicant documents a substantial need for 
the proposed program and activities.
    2. Long Term Goals (20 points).
    The quality of the applicant's stated goals and the extent to which 
they are consistent with the purpose of this cooperative agreement, as 
described in this program announcement.
    3. Program Plan (60 total points).
    a. Involvement of the target population (10 points): The degree to 
which the applicant describes the involvement of the target population 
in planning, implementing, and evaluating activities and services 
throughout the project period. Are plans to include both sexes and 
minorities and their subgroups adequately developed (as appropriate for 
the scientific goals of the project)?
    b. Program Objectives (10 points): Degree to which the proposed 
objectives are specific, measurable, time-phased, related to the 
proposed activities, and consistent with the program's long-term goals; 
the extent to which the applicant identifies possible barriers to or 
facilitators for reaching these objectives.
    c. Plan of Operation (10 points): The quality of the applicant's 
plan for conducting program activities, the assurance of an integrated 
approach, and the potential effectiveness of the proposed activities in 
meeting objectives.
    d. Appropriateness of Interventions and Care (10 points): The 
degree to which the applicant describes how the proposed priority 
interventions and services are culturally tailored, sensitive to issues 
of sexual identity, developmentally appropriate, linguistically-
specific, and educationally appropriate; and the degree to which the 
applicant describes the specific behaviors, practices, and health 
outcomes that the interventions and care are designed to promote and 
prevent (i.e., medication compliance, enrollment in early intervention 
programs, increases in correct and consistent condom use, knowledge of 
serological status, not sharing needles, and enrollment in drug 
treatment and other preventive programs).
    e. Coordination/Collaboration (5 points): Appropriateness of 
collaboration and coordination with other organizations serving the 
same priority populations. At minimum, the applicant provides a 
description of the collaboration and a signed memoranda of agreement 
for each agency with which collaborative activities are proposed, and 
other evidence of collaboration that describes previous, current, as 
well as future areas of collaboration.
    f. Description of Evaluation Plan (5 Points): Thoroughness, 
feasibility and appropriateness of the project's evaluation design from 
a methodological and statistical perspective. The process and outcome 
objectives to be studied. Process outcomes that evaluate the success of 
the model being implemented. Outcome measures that center upon 
participation prevention activities, primary health care, and where 
applicable, client health, and client satisfaction.
    g. Time line (5 points): The extent to which the applicant's 
proposed time line is specific and realistic.
    h. The degree to which the applicant has met the CDC policy 
requirements regarding the inclusion of women, ethnic, and racial 
groups in the proposed research (5 points). This includes:
    (1) The proposed plan for the inclusion of both sexes and racial 
and ethnic minority populations for appropriate representation.
    (2) The proposed justification when representation is limited or 
absent.
    (3) A statement as to whether the design of the study is adequate 
to measure differences when warranted.
    (4) A statement as to whether the plans for recruitment and 
outreach for study participants include the process of establishing 
partnerships with communities and recognition of mutual benefits.
    4. Budget/Staffing Breakdown and Justification (not scored).
    Personnel: Appropriateness of the staffing pattern for the proposed 
project.
    Budget: Appropriateness of the budget for the proposed project.
    5. Training and Technical Assistance Plan (not scored): The extent 
to which the applicant describes areas in which technical assistance is 
anticipated in designing, implementing, and evaluating the proposed 
program. The extent to which the applicant describes anticipated staff 
training needs related to the proposed program and how these needs will 
be met.
    6. Does the application adequately address the requirements of 
title 45 CFR Part 46 for the protection of human subjects?

H. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. Annual progress reports;
    2. Financial status report, no more than 90 days after the end of 
the budget period; and
    3. Final financial status and performance reports, no more than 90 
days after the end of the project period.
    Send all reports to: Sheri Disler, Grants Management Specialist, 
Grants Management Branch, Procurement and Grants Office, Centers for 
Disease Control and Prevention (CDC), 2920 Brandywine Rd., Room 3000, 
Mail Stop E-15, Atlanta, GA 30341-4146, Telephone (770) 488-2756.
    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment I in the 
application kit.

AR-1  Human Subjects Requirements
AR-2  Requirements for Inclusion of Women and Racial and Ethnic 
Minorities in Research
AR-4  HIV/AIDS Confidentiality Provisions
AR-5  HIV Program Review Panel Requirements
AR-6  Patient Care
AR-7  Executive Order 12372 Review
AR-8  Public Health System Reporting Requirements
AR-9  Paperwork Reduction Act Requirements
AR-10  Smoke-Free Workplace Requirements
AR-11  Healthy People 2000
AR-12  Lobbying Restrictions

I. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under sections 301 and 317(k), of the 
Public Health Service Act [42 U.S.C. 241 and 247b(k)], as amended. The 
HRSA Special Projects of National Significance (SPNS) program is 
authorized by Section 2691 of the Public Health Service Act (42 
U.S.C.300ff-10). The Catalog of Federal Domestic Assistance number is 
93.941.

J. Where To Obtain Additional Information

    Please refer to Program Announcement 99099 when you request 
information. For a complete program description, information on 
application procedures, an application package, and business management 
technical assistance, contact: Kevin Moore or Sheri Disler, Grants 
Management Specialist, Grants Management Branch, Procurement and Grants 
Office,

[[Page 27570]]

Announcement 99099, Centers for Disease Control and Prevention (CDC), 
2920 Brandywine Road, Mail Stop E-15, Atlanta, GA 30341, Telephone 
(770) 488-2720, Email address: [email protected] or [email protected]
    A full application package is also available on the CDC home page 
on the Internet: http://www.cdc.gov.
    For program technical assistance, contact John Miles at (404) 639-
8025 or [email protected].
    See also the CDC home page on the Internet: http://www.cdc.gov.

    Dated: May 14, 1999.
Henry S. Cassell III,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention (CDC).
[FR Doc. 99-12694 Filed 5-19-99; 8:45 am]
BILLING CODE 4163-18-P