[Federal Register Volume 66, Number 53 (Monday, March 19, 2001)]
[Notices]
[Pages 15481-15484]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-6715]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Availability of Funds for Grants for the Bilingual/Bicultural 
Service Demonstration Program

AGENCY: Office of the Secretary, Office of Public Health and Science, 
Office of Minority Health, HHS.

ACTION: Notice of availability of funds and request for applications 
for the Bilingual/Bicultural Service Demonstration Grant Program.

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Program Title

    Bilingual/Bicultural Service Demonstration Grant Program.

    OMB Catalog of Federal Domestic Assistance: The OMB Catalog of 
Federal Domestic Assistance number for the Bilingual/Bicultural 
Service Demonstration Program is 93.105.

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

Purpose

    The purpose of this Fiscal Year 2001 Bilingual/Bicultural Service 
Demonstration Grant Program is to:
    1. Improve and expand the capacity for linguistic and cultural 
competence of health care professionals and paraprofessionals working 
with limited-English-proficient (LEP) minority communities; and
    2. Improve the accessibility and utilization of health care 
services among the LEP minority populations.
    These grants are intended to demonstrate the merit of programs that 
involve partnerships between minority community-based organizations and 
health care facilities in a collaborative effort to:
     Address cultural and linguistic barriers to effective 
health care service delivery; and
     Increase access to effective health care for the LEP 
minority populations living in the United States.

Eligible Applicants

    To qualify for funding, an applicant must:
    1. Be a private non-profit, minority or public community-based 
organization which addresses health or human services (see definition 
found in this announcement).
    2. Provide services to a targeted LEP minority community.
    3. Have an established linkage with a health care facility. Local 
affiliates of national organizations which have an established link 
with a health care facility are eligible to apply. The linkage must:

     Involve two separate and distinct entities.
     Be documented in writing as specified under the project 
requirements described in this announcement.
    The organization submitting the application will:
     Serve as the lead agency for the grant.
     Be responsible for management of the project.
     Serve as the fiscal agent for the federal grant awarded.
    Organizations are not allowed to receive funding from more than one 
Office of Minority Health (OMH) grant program a time. An organization 
may submit only one proposal under this announcement.


    Note: National, state-wide, and regional organizations, for-
profit hospitals, universities, and schools of higher learning may 
not apply for these grants.

Availability of Funds

    About $1.25 million is expected to be available for award in FY 
2001. It is expected that 9 to 15 community-based organizations (CBOs) 
will receive awards.


    Note: It is anticipated that $500,000 of the total funding will 
be awarded to projects that include HIV/AIDS as one of the targeted 
health problem areas.


    Those applicants chosen through the competitive process:
     Are to begin their service demonstration programs on 
September 30, 2001.
     Will receive an award ranging from $75,000 to $150,000 
total costs (direct and indirect) for a 12 month period.
     Will be able to receive noncompeting continuation awards 
for an additional 2 years. After year 1, funding is based on:

--The amount of money available; and
--Success or progress in meeting project objectives.


    Note: For the non-competing continuation awards, grantees must 
submit continuation

[[Page 15482]]

applications, written reports, and continue to meet the established 
funding guidelines.


     Continuation awards are expected to range from $75,000 to 
$150,000. The actual funding level will depend on the availability of 
funds.

Use of Grant Funds

    Budgets ranging between $75,000 to $150,000 total costs (direct and 
indirect) may be requested per year to cover costs of:

 Personnel
 Consultants
 Supplies including screening and outreach supplies
 Equipment
 Grant related travel
 Other grant related costs

    Funds may not be used for:

 Medical treatment
 Building alterations or renovations
 Construction


    Note: All budget requests must be fully justified in terms of 
the proposed purpose and objectives. Funds to attend an annual OMH 
grantee meeting must be included in the budget.

Background

    In the United States today, millions of people are not able to 
speak, read, write, or understand the English language at a level that 
permits them to interact with their English only health care providers 
or social services agencies. This can result in barriers in patients' 
getting to programs, or delays or denial of their services or care. 
Often, the client may walk away with inaccurate or incomplete health 
information.
    The OMH is committed to working with CBOs to offer activities and 
services for people with limited English skills.
    OMH aims to reach people with limited English proficiency, many of 
whom are members of racial or ethnic populations. To that end, OMH 
began the Bilingual/Bicultural Service demonstration Program in 1993. 
The Program works to build communication bridges and reduce barriers to 
care for members of LEP communities though offering funding of 
demonstration projects.

Project Requirements

    Each project funded under this demonstration program is to:
    1. Address at least 1, but no more than 3 problem health areas 
identified in the section on Health Areas to be Addressed.
    2. Carry out activities to improve and expand the capacity of 
health care providers and other health care professionals to deliver 
culturally and linguistically appropriate health care services to the 
target population.
    3. Carry out activities to improve access to health care for the 
LEP population.
    4. Have an established, formal linkage between the community-based 
organization and a health care facility, prior to submission of an 
application. The linkage must involve two separate and distinct 
entities.
    A single signed agreement between the applicant organization and 
the partner organization must be submitted with the application. The 
agreement must specify in detail the roles and resources that each 
entity will bring to the project, and the terms of the linkage. The 
linkage agreement must cover the entire project period.
    The document must be signed by individuals with the authority to 
represent the organization (e.g., president, chief executive officer, 
executive director).

Health Areas to be Addressed

    In FY 2001, the Bilingual/Bicultural Service Demonstration Program 
will target 21 health areas which are part of the Healthy People 2010 
focus areas.
    An applicant is required to address at least 1, but no more than 3 
of the following health areas for its demonstration project:

 Access to Quality Health Services
 Arthritis, Osteoporosis, and Chronic Back Conditions
 Cancer
 Chronic Kidney Disease
 Diabetes
 Environmental Health
 Family Planning
 Heart Disease and Stroke
 HIV
 Immunization and Infectious Disease
 Injury and Violence Prevention
 Maternal, Infant, and Child Health
 Mental Health and Mental Disorders Conditions
 Nutrition and Overweight
 Oral Health
 Physical Activity and Fitness
 Respiratory Diseases
 Sexually Transmitted Diseases
 Substance Abuse
 Tobacco Use
 Vision and Hearing

Application Kit

     For this grant, you must use form PHS 5161-1 (Revised June 
1999 and approved by OMB under Control Number 0937-0189).
     You are advised to pay close attention to the specific 
program guidelines and general instructions provided in the application 
kit.
     To get an application kit, write to: Ms. Karen Campbell, 
Acting Grants Management Officer, Division of Management Operations, 
Office of Minority Health, Rockwall II Building, Suite 1000, 5515 
Security Lane, Rockville, MD 20852; or, call Karen Campbell at: (301) 
594-0758.

Where to Send Applications

    Send the original and 2 copies of the complete grant application 
to: Ms. Karen Campbell, Acting Grants Management Officer, Division of 
Management Operations, Office of Minority Health, Rockwall II Building, 
Suite 1000, 5515 Security Lane, Rockville, MD 20852.

Application Deadline

    To receive consideration, grant applications must be received by 
the OMH Grants Management Office by May 18, 2001. 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.

How to Get Help

    In addition to contacting Karen Campbell for application kits, she 
may also be contacted for technical assistance on budget and business 
aspects of the application. For questions on the program and assistance 
in preparing a grant proposal, contact: Ms. Cynthia H. Amis, Director, 
Division of Program Operations, Office of Minority Health, Rockwall II 
Building, Suite 1000, 5515 Security Lane, Rockville, MD 20852; or, call 
Cynthia Amis at: (301) 594-0769.
    For additional assistance contact OMH Regional Minority Health 
Consultants listed in the grant application kit.
    For health information call the OMH Resource Center at 1-800-444-
6472.

Review of Application

     Applications will be screened upon receipt. Applications 
that are not complete or do not conform to or address the criteria of 
the announcement will be returned without comment.

[[Page 15483]]

     Each organization may submit no more than one proposal 
under this announcement.
     Organizations submitting more than one proposal will be 
deemed ineligible. The proposals will be 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. Panel members are chosen for their expertise in minority health 
and their understanding of the unique health problems and related 
issues confronted by the racial/ethnic minority populations in the 
United States.

Application Review Criteria

    The technical review of applications will consider the following 5 
generic factors.
Factor 1: Background (15%)
 Demonstrated knowledge of the problem at the local level
 Demonstrated need within the proposed community and target 
population
 Demonstrated support and established linkage(s) in order to 
conduct the proposed model
 Extent and documented outcome of past efforts and activities 
with the target population
Factor 2: Objectives (15%)
 Merit of the objectives
 Relevance to the program purpose and stated problem
 Attainability in the stated time frames
Factor 3: Methodology (35%)
 Appropriateness of proposed approach and specific activities 
for each objective
 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 linkage(s)
Factor 4: Evaluation (20%)
 Thoroughness, feasibility and appropriateness of the 
evaluation design, data collection and analysis procedures
 Clarity of the intent and plans to document the activities and 
their outcomes
 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
--Staff level of effort
--Management experience of the applicant
--Experience of each member of the linkage 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, OMH and will take under consideration:

 The recommendations and ratings of the review panel
 Geographic and racial/ethnic distribution
 Whether the proposed project will take place in Empowerment 
Zones and Enterprise Communities

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 OMH, in accordance with provisions of the general regulations 
which apply under 45 CFR Part 74.51-74.52, with the exception of State 
and local governments to which 45 CFR Part 92, Subpart C reporting 
requirements apply.

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

    The PHS strongly encourages all grant recipients to provide a 
smoke-free workplace and to promote the nonuse 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 available under this 
notice will contain a list 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 application deadline established by the OMH Grants 
Management Officer. The OMH 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.)
    Healthy People 2010: The PHS is committed to achieving the health 
promotion and disease prevention objectives of Healthy People 2010, a 
PHS-led national activity announced in January 2000 to eliminate health 
disparities and improve years and quality of life. More information on 
the Healthy People 2010 objectives may be found on the Healthy People 
2010 web

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site: http://www.health.gov/healthypeople. Copies of the Healthy People 
2010: Volumes I and II can be purchased by calling (202) 512-1800 (cost 
$70 for printed version or $19 for CDROM). Another reference is the 
Healthy People 2000 Review--1998-99.
    For 1 free copy of Healthy People 2010, contact NCHS: The National 
Center for Health Statistics, Division of Data Services, 6525 Belcrest 
Road, Hyattsville, MD 20782-2003; or telephone (301) 458-4636; ask for 
DHHS Publication No. (PHS) 99-1256.
    This document may also be downloaded from the NCHS web site: http://www.cdc.gov/nchs.

Additional Background Information

    In FY 1993, OMH launched the Bilingual/Bicultural Service 
Demonstration Program to specifically address the linguistic, cultural 
and social barriers the LEP minority populations encounter when 
accessing health services. In addition, the program recognized other 
factors which contribute to the poor health status of LEP minorities 
including:

 Inadequate number of health care providers and other health 
care professionals who are culturally competent and skilled in 
providing linguistically appropriate services
 Shortage of trained interpreters at the community level
 Limited knowledge about appropriate mechanisms to address 
language barriers in health settings
 Lack of effective partnerships between major mainstream 
provider organizations and LEP minority communities
 Geographic isolation
 Low economic status
 Lack of health insurance
 Organizational barriers
    These factors continue to hinder the LEP populations' ability to 
access and attain quality health care. Therefore, it is essential that 
health care providers, health care professionals, and other staff 
become informed about the diverse linguistic, cultural and medical 
perspectives of the clientele.
    Enhancement of cultural and linguistic competency among these 
individuals should increase LEP minority populations' knowledge of the 
Western health care model, and increase their access to and willingness 
to accept appropriate health care.
    In a further effort to insure that all people entering the health 
care system receive equitable and effective treatment in a culturally 
and linguistically appropriate manner, the OMH finalized the National 
Standards on Culturally and Linguistically Appropriate Services (CLAS) 
in Health Care on December 22, 2000.
    While these 14 standards are primarily directed at health care 
organizations, the principals and activities of culturally and 
linguistically appropriate services should be undertaken in partnership 
with communities being served. OMH encourages minority community-based 
organizations to work with partner health care facilities to implement 
activities addressing those CLAS standards that have applicability to 
the purposes of the Bilingual/Bicultural Service Demonstration Program.

Definitions

    For purposes of this grant announcement, the following definitions 
are provided:
    Community-Based Organization--Private, nonprofit organizations and 
public organizations that are representative of communities or 
significant segments of communities where the control and decision-
making powers are located at the community level.
    Cultural Competency--The ability to understand and appreciate 
cultural differences and similarities within, among and between groups. 
This requires a willingness and ability to draw on community-based 
values, traditions and customs, and to work with knowledgeable persons 
of and from the community in developing focused interventions, 
communications and other supports. (Orlandi, Mario A., 1992.)
    Health Care Facility--A private, nonprofit or public facility that 
has an established record for providing comprehensive health care 
services to a targeted, LEP racial/ethnic minority community.
    A health care facility may be a hospital, outpatient medical 
facility, community health center, migrant health center, or a mental 
health center. Facilities providing only screening and referral 
activities are not included in this definition.
    Limited-English-Proficient Populations (LEP)--People from Minority 
Populations (see definition below) with a primary language other than 
English. These individuals must communicate in their main language in 
order to participate effectively in and benefit from any aid, service 
or benefit provided by the health provider.
    Minority Community-Based Organization--Private, non-profit, 
community-based organizations or local affiliates of a national 
organizations that have: a governing board composed of 51 percent or 
more racial/ethnic minority members and a significant number of 
minorities in key program positions.

Minority Populations

 American Indian or Alaska Native
 Asian
 Black or African American
 Hispanic or Latino
 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.)

    Dated: March 8, 2001.
Nathan Stinson, Jr.,
Deputy Assistant Secretary for Minority Health.
[FR Doc. 01-6715 Filed 3-16-01; 8:45 am]
BILLING CODE 4160-17-P