[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
[[Page 33085]]
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.
[[Page 33086]]
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
[[Page 33087]]
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