[Federal Register Volume 64, Number 118 (Monday, June 21, 1999)]
[Notices]
[Pages 33083-33087]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-15635]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary
Office of Minority Health


Availability of Funds for Grants for the Minority Community 
Health Coalition Demonstration Program, HIV/AIDS

AGENCY: Office of the Secretary, Office of Minority Health.

ACTION: Notice of availability of funds and request for applications 
for the Minority Community Health Coalition Demonstration Grant 
Program, HIV/AIDS.

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Purpose

    The purpose of this Fiscal Year 1999 Minority Community Health 
Coalition Demonstration Grant Program, HIV/AIDS is to improve the 
health status, relative to HIV/AIDS, of targeted minority populations 
through health promotion and education activities. This program is 
intended to demonstrate the effectiveness of community-based coalitions 
involving non-traditional partners in:
    (1) Developing an integrated community-based response to the HIV/
AIDS crisis through community dialogue and interaction;
    (2) Addressing sociocultural, linguistic and other barriers to HIV/
AIDS treatment to increase the number of individuals seeking and 
accepting services; and
    (3) Developing and conducting HIV/AIDS education and outreach 
efforts for hardly reached populations.
    The overall goal is to increase the health status of minority 
populations by increasing the educational understanding of HIV/AIDS, 
increased testing, and improving the access to HIV/AIDS prevention and 
treatment services.
    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of Healthy People 
2000, a PHS-led national activity of setting priority areas. This 
announcement, the Minority Community Health Coalition Demonstration 
Grant Program, HIV/AIDS, is related to four of the 22 priority areas 
(1) Alcohol and other drugs; (2) educational and community-based 
programs; (3) HIV Infection; and (4) sexually transmitted diseases. 
Potential applicants may obtain a copy of Health People 2000 (Full 
Report: Stock No. 017-001-00474-0) or Healthy People 2000 (Summary 
Report: Stock No. 017-001-0473-1) through the Superintendent of 
Documents,

[[Page 33084]]

Government Printing Office, Washington, DC 20402-9325 or telephone 
(202) 783-3238.

Background

    The Minority Community Health Coalition Demonstration Grant 
Program, HIV/AIDS is based on the hypothesis that the community 
coalition approach to health promotion and education activities can be 
effective in reaching minority target populations--especially those 
most at risk or hardly reached. Among the merits of using coalitions is 
the higher likelihood that: (1) The intervention will be culturally and 
linguistically competent, credible and more acceptable to the target 
population; (2) the project will address HIV/AIDS within the context of 
related socio-economic issues; and (3) the effort will contribute to 
overall community empowerment by strengthening indigenous leadership 
and organizations. The OMH is continuing, through this announcement, to 
promote the utilization of community coalitions to develop and 
implement health promotion/education activities to specifically focus 
on HIV/AIDS. The OMH is also interested in involving those 
organizations in the coalition that have not traditionally been 
involved in HIV/AIDS prevention activities or services and outreach 
(e.g., sororities/fraternities, rotary clubs, religious affiliates) so 
that hardly reached populations (e.g. inmates, homeless, women at risk, 
youth) are provided the services they need. By including organizations 
that have not traditionally been involved in HIV/AIDS activities, the 
community coalition will expand its network and ability to access and 
serve these hardly reached populations. Applicants are also encouraged 
to establish linkages with other federally funded programs supporting 
HIV prevention and care to maximize these efforts.

Disproportionate Effect of HIV/AIDS on Minorities

    Current statistics from the Centers for Disease Control and 
Prevention (CDC) indicate that Blacks and Hispanics are 
disproportionately represented among the more than 640,000 people with 
AIDS that have been reported in the United States. While Blacks and 
Hispanics respectively represent approximately 13% and 10% of the U.S. 
population, 45% of people with AIDS reported in 1997 were Black and 21% 
were Hispanic. Asian/Pacific Islanders and Native Americans 
respectively represent 4% and 1% of the U.S. population and currently 
each account for 1% of people with AIDS. During 1997, the rate of new 
AIDS cases per 100,000 population in the U.S. was 83.7 among Blacks, 
37.7 among Hispanics, 10.4 among whites, 10.4 among American Indians/
Alaska Natives, and 4.5 among Asians/Pacific Islanders. Although Asian/
Pacific Islanders and Native Americans do not appear to be 
disproportionately affected by HIV infection, it is believed that the 
low rate may be due in part to undercounting issues, especially in the 
Native American population.
    The behaviors that increase the risk of infection with HIV include: 
unprotected sexual intercourse; the sharing of HIV infected needles or 
other drug paraphernalia; and having numerous unprotected sexual 
partners (homosexual or heterosexual). People who engage in more than 
one of these behaviors, for example, individuals who have unprotected 
sex with someone who injects drugs and shares needles or other 
``works'', are at especially high-risk. HIV infections associated with 
use of injected drugs involve not only drug users themselves, but their 
sex partners and infants as well. Users of non-injected drugs, e.g. 
crack, who sell sexual favors to support their habit often expose 
themselves to multiple potentially infected partners.
    Surveillance data shows that a large proportion of AIDS cases among 
minorities are diagnosed in the 20 to 29 year old age group, indicating 
HIV infection in adolescence or early 20's. Given the data regarding 
the incidence of the disease among teenagers, adolescents and adults, 
it is imperative to conduct targeted outreach activities to implement 
comprehensive HIV/AIDS prevention and education programs in racial/
ethnic communities to reach these populations.

HIV/AIDS and Sexually Transmitted Diseases (STDs)

    The behaviors which place individuals at risk for other STDs also 
increase a person's risk of becoming infected with HIV. Prevention 
through individual behavior change is the only method currently 
available to stop the spread of HIV infection. According to the CDC, 
biological studies suggest both increased susceptibility to HIV 
infection and increased likelihood of infecting other people when STDs 
are present. STD surveillance can provide important indications of 
where HIV infection may spread, and where efforts to promote safer 
sexual behaviors should be targeted. Therefore, it is important that 
HIV education and prevention programs integrate STDs as health care 
problems associated with the high-risk behaviors underlying HIV 
transmission.
    Eligible Applicants: Public and private, nonprofit minority 
community-based organizations which represent a community coalition of 
at least three discrete organizations (see definitions of Minority 
Community-Based Organizations, Community Coalition and AIDS Service 
Organization found in this announcement.) The applicant and at least 
one of the three organizations must have significant experience in 
conducting HIV/AIDS education, prevention and outreach activities. As 
the applicant, the minority community-based organization must have at 
least five years or more experience in HIV/AIDS. One of the three 
organizations must be an AIDS Service Organization (ASO) with at least 
three years of experience. Additionally, at least one of the coalition 
members must be an organization rooted in the community, but with 
limited experience conducting HIV/AIDS programs.
    In order to maximize the use of the limited resources available for 
this program and to address efforts where the HIV/AIDS problem is most 
prevalent, eligible applicants must be located in one of the following 
15 metropolitan statistical areas. These are the areas indicated by the 
CDC in its HIV/AIDS Surveillance Reports for 1996 and 1997 as having 
the highest number of newly reported AIDS cases in 1995, 1996 and 1997.

 Atlanta, GA
 Baltimore, MD
 Boston, MA
 Chicago, IL
 Dallas, TX
 Ft. Lauderdale, FL
 Houston, TX
 Los Angeles, CA
 Miami, FL
 New York, NY
 Newark, NJ
 Philadelphia, PA
 San Francisco, CA
 San Juan, PR
 Washington, DC

    The minority community-based organization will: serve as the lead 
agency for the grant; be responsible for management of the project; and 
serve as the fiscal agent for the Federal grant awarded. The coalition 
membership must be documented as specified under the project 
requirements described in this announcement.
    National organizations, universities and schools of higher learning 
are not eligible to apply. However, local affiliates of national 
organizations which meet the definition of a minority community-based 
organization are eligible. Currently funded OMH grantees are not 
eligible to apply (e.g., Minority Community Health Coalition

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Demonstration Program, Bilingual/Bicultural Service Demonstration 
Program). Organizations are not eligible to receive funding from more 
than one OMH grant program.
    Deadline: To receive consideration, grant applications must be 
received by the Office of Minority Health (OMH) Grants Management 
Office by July 21, 1999. Applications will be considered as meeting the 
deadline if they are: (1) Received on or before the deadline date, or 
(2) postmarked on or before the deadline date and received in time for 
orderly processing. A legibly dated receipt from a commercial carrier 
or U.S. Postal Service will be accepted in lieu of a postmark. Private 
metered postmarks will not be accepted as proof of timely mailing. 
Applications submitted by facsimile transmission (FAX) or any other 
electronic format will not be accepted. Applications which do not meet 
the deadline will be considered late and will be returned to the 
applicant unread.
    Addresses/Contacts: Applications must be prepared using Form PHS 
5161-1 (Revised May 1996 and approved by OMB under control Number 0937-
0189). Application kits and technical assistance on budget and business 
aspects of the application may be obtained from Ms. Carolyn A. 
Williams, Grants Management Officer, Division of Management Operations, 
Office of Minority Health, Rockwall II Building, Suite 1000, 5515 
Security Lane, Rockville, MD 20852, telephone (301) 594-0758. Completed 
applications are to be submitted to the same address.
    Questions regarding programmatic information and/or requests for 
technical assistance in the preparation of grant applications should be 
directed to Ms. Cynthia H. Amis, Director, Division of Program 
Operations, Office of Minority Health, Rockwall II Building, Suite 
1000, 5515 Security Lane, Rockville, MD 20852, telephone (301) 594-
0769.
    Technical assistance is also available through the OMH Regional 
Minority Health Consultants (RMHCs). A listing of the RMHCs and how 
they may be contacted will be provided in the grant application kit. 
Additionally, applicants can contact the OMH Resource Center (OMH-RC) 
at 1-800-444-6472 for health information.
    Availability of Funds: Approximately $2.5 million is to be 
available for award in FY 1999. It is projected that awards of up to 
$150,000 total costs (direct and indirect) for a 12 month period will 
be made to approximately 13-15 competing applicants.
    Period of Support: The start date for the Minority Community Health 
Coalition Demonstration Program, HIV/AIDS grants is September 30, 1999. 
Support may be requested for a total project period not to exceed 3 
years. Noncompeting continuation awards of up to $150,000 will be made 
subject to satisfactory performance and availability of funds.
    Project Requirements: Each applicant to this demonstration grant 
program must:
    (1) Propose to conduct a replicable, model program using an 
integrated community-based response to the HIV/AIDS crisis through 
community dialogue and interaction designed to improve the health 
status of targeted minority populations.
    (2) Have a coalition capable of ensuring that the target population 
is provided with HIV/AIDS health promotion and education outreach 
activities that are linguistically, culturally and age appropriate 
especially for hardly reached populations.
    (3) Engage minority communities in activities that will impact 
attitudes and perceptions in these communities to increase the number 
of individuals seeking and accepting services.
    (4) The coalition must consist of at least three discrete 
organizations which include: (1) a minority community-based 
organization; (2) an ASO; and, (3) one organization rooted in the 
community with limited experience in HIV/AIDS activities. As the lead, 
the minority community-based organization must have at least five years 
of documented experience in conducting HIV/AIDS education and health 
promotion activities. The coalition must include an ASO with at least 
three years of documented experience to ensure that information 
dissemination on HIV/AIDS and related issues is current and accurate 
from a medical point of view. The coalition must also include at least 
one organization rooted in the community that has not traditionally 
been involved in HIV/AIDS activities.
    (5) Provide signed documentation between the applicant and each 
coalition member which specifies, in detail: (a) the roles and 
resources that each entity will bring to the project, and (b) states 
the duration and terms of the agreement. The document must be signed by 
representatives with authority from all the member organizations 
including the applicant (e.g., president, chief executive officer, 
executive director).
    Use of Grant Funds: Budgets of up to $150,000 total cost (direct 
and indirect) per year may be requested to cover costs of: personnel, 
consultants, supplies, equipment, and grant related travel. Funds may 
not be used for medical treatment, construction, building alterations, 
or renovations. All budget requests must be fully justified in terms of 
the proposed goals and objectives and include a computational 
explanation of how costs were determined.

Criteria for Evaluating Applications

Review of Application

    Applications will be screened upon receipt. Those that are judged 
to be incomplete, non-responsive to the announcement or nonconforming 
will be returned without comment. Each applicant may submit no more 
than one proposal under this announcement. If an organization submits 
more than one proposal, all will be deemed ineligible and returned 
without comment. Accepted applications will be reviewed for technical 
merit in accordance with PHS policies. Applications will be evaluated 
by an Objective Review Panel chosen for their expertise in minority 
health, experience relevant to this program, and their understanding 
and knowledge of the health problems and risk factors confronting 
racial and ethnic minorities in the United States.
    Applicants are advised to pay close attention to the specific 
program guidelines and general instructions provided in the application 
kit.

Application Review Criteria

    The technical review of applications will consider the following 
generic factors.
Factor 1: Background (15%)
    Adequacy of demonstrated knowledge of the problem at the local 
level; demonstrated need within the proposed community and target 
population; demonstrated support of local agencies and/or 
organizations, and established linkages in order to conduct proposed 
model; and extent and documented outcome of past efforts/activities 
with the target population.
Factor 2: Goals and Objectives (15%)
    Merit of the objectives, their relevance to the program purpose and 
stated problem, and their attainability in the stated time frames.
Factor 3: Methodology (35%)
    Appropriateness of proposed approach and specific activities for 
each objective and target group. Logic and sequencing of the planned 
approaches in relation to the objectives and program evaluation. Extent 
to which the applicant demonstrates access to the target population. 
Soundness of the established linkages.

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Factor 4: Evaluation (20%)
    Thoroughness, feasibility and appropriateness of the evaluation 
design, and data collection and analysis procedures. Clarity of the 
intent and plans to document the activities and their outcomes to 
establish a model. The potential for replication of the project for 
similar target populations and communities.
Factor 5: Management Plan (15%)
    Applicant organization's capability to manage and evaluate the 
project as determined by: the qualifications of proposed staff or 
requirements for ``to be hired'' staff; proposed staff level of effort; 
management experience of the lead agency; and experience of each 
coalition member as it relates to its defined roles and the project.

Award Criteria

    Funding decisions will be determined by the Deputy Assistant 
Secretary for Minority Health, Office of Minority Health and will take 
under consideration: recommendations/ratings of the review panels and 
geographic and racial/ethnic distribution. Consideration will also be 
given to projects proposed to be implemented in Empowerment Zones and 
Enterprise Communities in the 15 eligible metropolitan statistical 
areas and those which reach out to neighboring rural communities 
impacted by the HIV/AIDS epidemic.

Definitions

    For purposes of this grant announcement, the following definitions 
are provided:
    AIDS Service Organization (ASO)--A health association, support 
agency, or other service actively involved in the prevention and 
treatment of AIDS. (HIV/AIDS Treatment Information Service's Glossary 
of HIV/AIDS-Related Terms, March 1997.)
    Community-Based Organization--Public and private, non-profit 
organizations which are representative of communities or significant 
segments of communities, and which address health and human services.
    Community Coalition--At least three (3) discrete organizations and 
institutions in a community which collaborate on specific community 
concerns, and seeks resolution of those concerns through a formalized 
relationship documented by written memoranda of understanding/agreement 
signed by individuals with the authority to represent the organizations 
(e.g., president, chief executive officer, executive director).
    Cultural Competency--A set of behaviors, attitudes, and policies 
that enable a system, agency, and/or individual to function effectively 
with culturally diverse clients and communities. (Randall-David, E., 
1989)
    Intervention--An activity or series of activities (e.g., 
information dissemination, educational activities, coordinated network-
related activities) designed to alter or modify a condition or outcome, 
or to change behavior to reduce the likelihood of a preventable health 
problem occurring or progressing further.
    Minority Community-Based Organizations--Public and private 
nonprofit community-based minority organization or a local affiliate of 
a national minority organization that has: a governing board composed 
of 51 percent or more racial/ethnic minority members, a significant 
number of minorities employed in key program positions, and an 
established record of service to a racial/ethnic minority community.
    Minority Populations--American Indian or Alaska Native, Asian, 
Black or African American, Hispanic or Latino, and Native Hawaiian or 
Other Pacific Islander. (Revision to the Standards for the 
Classification of Federal Data on Race and Ethnicity, Federal Register, 
Vol. 62, No. 210, pg. 58782, October 30, 1997.)
    Risk Factor--The environmental and behavioral influences capable of 
causing ill health with or without predisposition.
    Sociocultural Barriers--Policies, practices, behaviors and beliefs 
that create obstacles to health care access and service delivery (e.g., 
cultural differences between individuals and institutions, cultural 
differences of beliefs about health and illness, customs and 
lifestyles, cultural differences in languages or nonverbal 
communication styles).

Reporting and Other Requirements

General Reporting Requirements

    A successful applicant under this notice will submit: (1) progress 
reports; (2) an annual Financial Status Report; and (3) a final 
progress report and Financial Status Report in the format established 
by the Office of Minority Health, in accordance with provisions of the 
general regulations which apply under CFR 74.50-74.52.

Provision of Smoke-Free Workplace and Non-Use of Tobacco Products by 
Recipients of PHS Grants

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

Public Health System Reporting Requirements

    This program is subject to Public Health Systems Reporting 
Requirements. Under these requirements, a community-based 
nongovernmental applicant must prepare and submit a Public Health 
System Impact Statement (PHSIS). The PHSIS is intended to provide 
information to State and local health officials to keep them apprised 
of proposed health services grant applications submitted by community-
based organizations within their jurisdictions.
    Community-based nongovernmental applicants are required to submit, 
no later than the Federal due date for receipt of the application, the 
following information to the head of the appropriate State and local 
health agencies in the area(s) to be impacted: (a) a copy of the face 
page of the application (SF 424), and (b) a summary of the project 
(PHSIS), not to exceed one page, which provides: (1) a description of 
the population to be served, (2) a summary of the services to be 
provided, and (3) a description of the coordination planned with the 
appropriate State or local health agencies. Copies of the letters 
forwarding the PHSIS to these authorities must be contained in the 
application materials submitted to the Office of Minority Health.

State Reviews

    This program is subject to the requirements of Executive Order 
12372 which allows States the option of setting up a system for 
reviewing applications from within their States for assistance under 
certain Federal programs. The application kit to be made available 
under this notice will contain a listing of States which have chosen to 
set up a review system and will include a State Single Point of Contact 
(SPOC) in the State for review. Applicants (other than federally 
recognized Indian tribes) should contact their SPOCs as early as 
possible to alert them to the prospective applications and receive any 
necessary instructions on the State process. For proposed projects 
serving more than one State, the applicant is advised to contact the 
SPOC of each affected State. The due date for State process 
recommendations is 60 days after the

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application deadline established by the Office of Minority Health's 
Grants Management Officer.
    The Office of Minority Health does not guarantee that it will 
accommodate or explain its responses to State process recommendations 
received after that date. (See ``Intergovernmental Review of Federal 
Programs'' Executive Order 12372 and 45 CFR Part 100 for a description 
of the review process and requirements).

    Authority: This program is authorized under section 1707(e)(1) 
of the Public Health Service Act, as amended by Public Law 105-392.

(OMB Catalog of Federal Domestic Assistance: The OMB Catalog of 
Federal Domestic Assistance number for the Minority Community Health 
Coalition Demonstration Program is 93-137.)

    Dated: June 9, 1999.
Nathan Stinson, Jr.,
Acting Deputy Assistant Secretary for Minority Health.
[FR Doc. 99-15635 Filed 6-18-99; 8:45 am]
BILLING CODE 4160-17-P