[Federal Register Volume 66, Number 72 (Friday, April 13, 2001)]
[Notices]
[Pages 19179-19181]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-9162]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Special Projects of National Significance Targeted HIV Outreach 
and Intervention Model Development; Evaluation and Program Support 
Center

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA) 
announces the availability of fiscal year (FY) 2001 funds to be awarded 
under the Special Projects of National Significance (SPNS) program for 
discretionary grants, under a new competition that supports the 
development and evaluation of models of targeted HIV outreach and 
intervention for under-served HIV-positive populations not in care. The 
purpose of this new grant initiative is to support multi-year projects 
that will refine and evaluate programs that identify individuals who 
are HIV-positive and not in health care and engage them in 
comprehensive and continual health care, and develop an evaluation and 
program support center to provide advice and technical assistance to 
the funded multi-year projects regarding program refinement and 
evaluation. Special emphasis is placed on reaching individuals from 
communities of color and under-served populations.
    The SPNS program is authorized by section 2691 of the Public Health 
Service Act. Grants may be awarded directly to public and non-profit 
private entities, including community-based organizations. The program 
has $3.5 million dollars available for this initiative. HRSA expects to 
make approximately 15 awards for demonstration projects and one award 
for the Evaluation and Program Support Center. The budget and project 
periods for approved and funded projects will begin on or about 
September 30, 2001. Funds for Category I awards must be requested for 
the initial two years. Funds for Category II must be requested for all 
five years.
    Funds will be awarded in two categories. In the first category 
(Category I), HRSA expects to award approximately fifteen (15) grants 
for the development and evaluation of models of targeted HIV outreach 
and intervention for under-served HIV-positive populations not in care. 
It is anticipated that in the first two years (Phase 1), each Category 
I site will be awarded $200,000 per year. For those study sites 
approved for continuation in years three through five (Phase 2), up to 
$400,000 per year will be available. All Category I grantees will be 
eligible to submit a competitive grant application during the second 
year for continuation funding for years three through five (Phase 2).
    In the second category (Category II), HRSA expects to award one 
award up to $500,000 per year for a five-year project period to support 
an Evaluation and Program Support Center. This Center will work with 
grantees to develop an overall multi-site evaluation of the grant 
initiative and provide technical support to grantees on program 
development and evaluation issues.
    Eligible applicants under Categories I and II may include, but are 
not limited to, State, local, or tribal public health, mental health, 
housing, or substance abuse departments; public or non-profit hospitals 
and medical facilities; community-based service organizations (e.g., 
AIDS service organizations, community and migrant health centers funded 
by HRSA's Bureau of Primary Health Care, other primary health care 
clinics, family planning centers, AIDS anti-discrimination and advocacy 
organizations, homeless assistance providers, hemophilia centers, 
community health or mental health centers, substance abuse treatment 
centers, urban and tribal Indian health centers or facilities, migrant 
health centers, etc.), institutions of higher education, and national 
service provider and/or policy development associations and 
organizations.
    Outreach projects proposed in Category I should seek to improve 
participation by HIV infected persons in HIV counseling and testing, 
diagnosis, prophylaxis, and treatment of manifestations and 
complications of HIV infection and AIDS, including: (a) Antiretroviral 
therapy, and (b) prophylactic therapy for opportunistic infections, 
including tuberculosis. Models of care should target under served 
populations and determine: the spectrum of HIV disease among treated 
and untreated HIV-infected persons (upon entry into care), the 
progression of HIV disease, adherence to antiretroviral treatment and 
PCP prophylaxis, and the impact of the model of care upon these 
parameters longitudinally. Models should include links to HIV 
counseling and testing services.
    During Phase 1 of the program (project years 1-2), Category I 
grantees are expected to continue to provide their existing outreach 
services while engaging in planning activities for the implementation 
and evaluation of an intervention during Phase 2 (project years 3-5) 
which may be: (1) A refinement and/or expansion of the intervention 
being implemented during Phase 1; or (2) a new intervention which was 
not being implemented during Phase 1. Phase 2 continuation awards will 
be made based on review by an external objective review committee which 
will use review criteria that is expected to consist of the Category I 
grantees' implementation of Phase 1 activities, success in implementing 
local and cross-site evaluation activities during Phase 1, and their 
ability to incorporate local and cross-site evaluation activities into 
the proposed Phase 2 scope of work.

[[Page 19180]]

    The SPNS program is designed to demonstrate and evaluate innovative 
and replicable HIV service delivery models. The authorizing legislation 
specifies three SPNS program objectives: (1) To support the development 
of innovative models of HIV care; (2) to evaluate the effectiveness of 
innovative program designs; and (3) to promote replication of effective 
models. Therefore, crucial factors in appraising proposals for outreach 
demonstration models will include, among other factors, the degree to 
which the applicant's plan improves access to and use of health care by 
individuals from vulnerable subpopulations and historically under-
served communities by identifying: (a) Proactive strategies for 
bringing minority and under served populations into health care when 
they are in early stages of HIV disease; (b) models that transform 
sporadic users of health care into regular and continual users of 
health care; and (c) effective methods to support and retain clients in 
health care.

DATES: Letters of Intent, to allow HRSA to plan for the Objective 
Review Process, are encouraged from all applicants. Such letters should 
be sent to: Barbara Aranda-Naranjo, PhD, RN, FAAN, Branch Chief, ATTN: 
2001 New HAB Competitive Initiative, Demonstration Program and 
Evaluation Branch, HIV/AIDS Bureau, Health Resources and Services 
Administration, Parklawn Building, Room 7C-07, 5600 Fishers Lane, 
Rockville, MD 20857 or faxed to: 301/443-4965. Such letters should be 
received by SPNS within 30 days after the publication of this Notice of 
Availability of Funds in the Federal Register. Receipt of these notices 
of intent will not be routinely acknowledged.
    Applications must be received in the HRSA Grant Application Center 
(GAC) by the close of business June 4, 2001 to be considered for 
competition. Applications will meet the deadline if they are either (1) 
received on or before the deadline date or (2) postmarked on or before 
the deadline date, and received in time for submission to the objective 
review panel. A legibly dated receipt from a commercial carrier or U.S. 
Postal Service will be accepted instead of a postmark. Private metered 
postmarks shall not be accepted as proof of timely mailing. 
Applications not accepted for processing will be returned to the 
applicant and will not be considered for funding.

ADDRESSES: The official grant application kit and guidance materials 
for this announcement may be obtained from the HRSA Grants Application 
Center, Attn: CFDA 93.928, 1815 N. Fort Meyer Drive, Suite 300, 
Arlington, VA 22209; telephone 877-477-2123, e-mail address 
[email protected]. Applicants are strongly advised to obtain the 
Guidance before preparing applications. Please mail completed 
applications to the HRSA Grants Application Center, previously 
described. Applicants for grants will use Revised Form PHS 5161-1, 
approved under OMB Control No. 0937-0189. This form may also be 
downloaded from the DHHS Program Support Center (PSC) website at: 
http://forms.psc.gov/forms/. All applications submitted to the SPNS 
program will be reviewed and rated by an objective review panel. 
Interested parties may access the guidance only on HRSA's web site at 
www.hrsa.hab.gov/grants.html.

FOR FURTHER INFORMATION CONTACT: Additional information regarding 
business, administrative, and fiscal issues related to the awarding of 
grants under this Notice may be requested from Ms. Janice Gordon, 
Grants Management Officer, HIV/AIDS Bureau, Health Resources and 
Services Administration, Parklawn Building, Room 7-89, 5600 Fishers 
Lane, Rockville, MD 20857; telephone 301/443-2385; fax 301/594-6096; e-
mail address [email protected].
    Additional information related to technical and program issues 
regarding the overall SPNS Program may be requested from Barbara 
Aranda-Naranjo, PhD, RN, FAAN, Branch Chief, ATTN: 2001 New Competitive 
Initiative, Demonstration Program and Evaluation Branch, HIV/AIDS 
Bureau, Health Resources and Services Administration, Parklawn 
Building, Room 7C-07, 5600 Fishers Lane, Rockville, MD 20857; telephone 
301/443-4149; fax 301/443-4965; e-mail address [email protected].
    Technical assistance regarding this funding announcement, may be 
requested from John Hannay, Special Program Consultant, Demonstration 
Program and Evaluation Branch, HIV/AIDS Bureau, Health Resources and 
Services Administration, Parklawn Building, 5600 Fishers Lane, Room 7C-
07, Rockville, MD 20857; tel. 301/443-0232; fax 410/730-6061; e-mail 
address [email protected].

Healthy People 2010 Objectives

    The Public Health Service urges applicants to address at least one 
of the Healthy People 2010 objectives in their work plans. Potential 
applicants may obtain a copy of Healthy People 2010 (Full Report) or 
Healthy People 2010 (Summary Report) through the Superintendent of 
Documents, Government Printing Office, Washington, DC 20402-9325 (Web 
site: http://www.access.gpo.gov; telephone: 202/512-1800).

SUPPLEMENTARY INFORMATION:   

Background and Objectives

    The SPNS program endeavors to advance knowledge and skills in HIV 
service delivery, to stimulate the design of innovative models of care, 
and to support the development of effective delivery systems for these 
services. SPNS accomplishes its purpose through funding, technical 
support and evaluation of innovative HIV service delivery models. HRSA 
has found that access to highly active antiretroviral therapy (HAART) 
and other care modalities reduces morbidity and mortality among people 
living with HIV, and that certain groups, particularly racial and 
ethnic minorities and women, have not benefited from such access and 
care as much as others. The reasons for these disparities are not well 
understood. They may include patients' awareness of available services, 
their understanding of when and how to use different components of the 
health care system, and their life concerns and priorities. The reasons 
may also include clinician characteristics and the organizational 
structures of health service providers. This announcement seeks 
applications from community-based programs that address the 
characteristics of targeted populations and the interactions between 
clients and their providers, and offer potential solutions to engaging 
minorities into care early in the course of HIV infection and achieving 
their consistent use of care. Further, the announcement seeks 
applications for an evaluation and program support center to work with 
grantees funded under Category I.
    This SPNS program encourages innovative projects to rigorously 
evaluate implementation, utilization, costs, and process and health 
outcomes. Proposed process and outcomes evaluation designs by 
demonstration project grantees (Category I) will form the basis for the 
cross-site evaluation conducted by the awardee in Category II. SPNS 
funds should be used to create models of outreach that would likely not 
exist without SPNS support, or would extend HIV services to previously 
under-served populations defined either geographically or 
demographically. Services provided through SPNS funding should 
currently not be reimbursed or eligible for current reimbursement 
through other sources, including Medicaid, third party payers, or other 
Ryan White programs. A model

[[Page 19181]]

may deliver services or products that are reimbursable, but the 
services supported by SPNS should not be.

Eligible Applicants

    The statute, section 2691(a) specifies that grants may be awarded 
to public and non-profit private entities to fund special programs for 
the care and treatment of people with HIV disease. Eligible applicants 
may include, but are not limited to, State, local, or tribal public 
health, mental health, housing, or substance abuse departments; public 
or non-profit hospitals and medical facilities; community-based service 
organizations (e.g., AIDS service organizations, community and migrant 
health centers funded by HRSA's Bureau of Primary Health Care, other 
primary health care clinics, family planning centers, AIDS anti-
discrimination and advocacy organizations, homeless assistance 
providers, hemophilia centers, community health or mental health 
centers, substance abuse treatment centers, urban and tribal Indian 
health centers or facilities, migrant health centers, etc.), 
institutions of higher education, and national service provider and/or 
policy development associations and organizations. Additionally, 
applicants in Category I must demonstrate experience in providing 
outreach services or other programs that are providing or linking HIV-
infected individuals from these under-served and vulnerable 
subpopulations with appropriate primary care and ancillary services on 
a regular basis.

Public Health System Reporting Requirements

    This program is also subject to the Public Health System Reporting 
Requirements which have been approved by the Office of Management and 
Budget under No. 0937-0195. Under these requirements, any community-
based, non-governmental applicant must prepare and submit a Public 
Health System Impact Statement (PHSIS). The PHSIS is intended to keep 
State and local health officials appraised of proposed health services 
grant applications submitted from within their jurisdictions.

Executive Order 12372

    The Special Projects of National Significance Grant Program has 
been determined to be a program subject to the provisions of Executive 
Order 12372, concerning intergovernmental review of Federal Programs, 
as implemented by 45 CFR Part 100.
    The OMB Catalog of Federal Domestic Assistance number for the 
Special Projects of National Significance is 93.928.

    Dated: April 9, 2001.
Elizabeth M. Duke,
Acting Administrator.
[FR Doc. 01-9162 Filed 4-12-01; 8:45 am]
BILLING CODE 4160-15-U