[Federal Register Volume 66, Number 119 (Wednesday, June 20, 2001)]
[Notices]
[Pages 33095-33099]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-15476]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 01106]


Addressing Asthma From a Public Health Perspective; Notice of 
Availability of Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2001 funds for a cooperative agreement 
program for ``Addressing Asthma from a Public Health Perspective.'' 
This program addresses the ``Healthy People 2010'' focus areas 
Environmental Health, Respiratory Diseases and Occupational Safety and 
Health.
    The purpose of the program is: Part A: Developing State Capacity to 
Address Asthma and Part B: Implementation of State Asthma Plans.
    This funding is not to be used for any type of research.

B. Eligible Applicants

    Assistance will be provided only to health departments of States or 
their bona fide agents, including the District of Columbia, the 
Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of 
the Northern Mariana Islands, American Samoa, Guam, the Federated 
States of Micronesia, the Republic of the Marshall Islands, the 
Republic of Palau, and federally recognized Indian tribal governments.
    In consultation with States, and with the written concurrence of 
the State, assistance may be provided to political subdivisions of 
States.
    Part A: Eligible applicants are those entities listed above that do 
not have a finalized comprehensive asthma plan or a well developed 
asthma surveillance system. Grantees currently funded by CDC 
Announcement #99109 (Attachment 1) are not eligible to apply.
    Part B: Eligible applicants are those entities listed above that 
have a completed comprehensive asthma plan and have an operational 
surveillance system for asthma. Grantees currently funded by CDC 
Announcement #99109 are eligible to apply. However, if awarded funds 
under Part B of this announcement, applicant will lose funds under 
Announcement #99109.
    An eligible applicant may apply for both Part A and Part B; 
however, only one award per applicant will be made. To apply for both 
parts of this announcement, applicants must submit separate 
applications for Part A and Part B.

    Note: Title 2 of the United States Code, Chapter 26, Section 
1611 states that an organization described in section 501(c)(4) of 
the Internal Revenue Code of 1986 that engages in lobbying 
activities is not eligible to receive Federal funds constituting an 
award, grant, cooperative agreement, contract, loan, or any other 
form.

C. Availability of Funds

    Approximately $3,600,000 is available in FY 2001 to fund awards 
under this announcement. Funding estimates may change.
    Part A: Developing State Capacity to Address Asthma. Approximately 
$2,000,000 is available to fund approximately 7-12 awards. It is 
expected that the average award will be $200,000. Additionally, 
$100,000 is available to increase Part A awards up to $10,000 each, if 
an occupational component is included in the application and is 
favorably reviewed.
    Part B: Implementation of State Asthma Plans. Approximately 
$1,500,000 is available to fund approximately 2-4 awards. It is 
expected that the average award will be $700,000.
    It is expected that the awards will begin on or about September 30, 
2001 and will be made for a 12-month budget period within a project 
period of up to 3 years for Part A and 5 years for Part B.
    Continuation awards within the approved project periods will be 
made on the basis of satisfactory progress as evidenced by required 
reports and the availability of funds.
    Applicant should document assurance of ability of project staff to 
travel to Atlanta to participate in the CDC National Asthma Conference 
and/or grantee meetings and willingness to share innovations, 
information, data and materials.

D. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1. 
(Recipient Activities), and CDC will be responsible for the activities 
listed under 2. (CDC Activities).

Part A. Developing State Capacity to Address Asthma

1. Recipient Activities:
    a. Develop or finalize a comprehensive State asthma plan.
    b. Develop and organize collaborative linkages with appropriate 
agencies and organizations.
    c. Implement a new (or enhance an existing) asthma surveillance 
system.
    d. Begin the statewide intervention program upon completion of the 
plan.

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    e. Evaluate all activities ongoing and document lessons learned at 
the end of the project.

Part B. Implementation of State Asthma Plans

    a. Maintain existing statewide coalition and partnership activities 
to oversee implementation and evaluation of the plan. Expand 
partnership activities as appropriate.
    b. Maintain existing asthma-related activities currently underway 
in the health agency and expand as appropriate.
    c. Implement defined aspects of the completed State/territorial/
tribal asthma plan. Assure institutionalization of intervention 
activities.
    d. Expand and continue existing surveillance efforts related to 
asthma occurrence, severity, management and other indicators in order 
to monitor the effectiveness of the intervention activities.
    e. Evaluate each intervention activity and the program as a whole; 
document lessons learned.
2. CDC Activities for Parts A and B
    a. Collaborate with the recipient in all stages of the project and 
coordinate joint activities among all grantees.
    b. Provide programmatic technical assistance, as requested.
    c . Convene meetings for grantees to share experiences, data, and 
materials.

E. Content

Letter of Intent (LOI)

    A one-page, non-binding LOI is requested, and it should include:
    1. Name and address of organization
    2. Contact person
    3. Which part of the announcement, Part A, Part B or both, applied 
for.
    The LOI will be used to ascertain the level of interest in this 
announcement and to assist in determining the size and composition of 
the independent review panel.

Applications

    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 30 pages for Part A, or 40 pages for Part B, 
double-spaced, printed on one side, with one inch margins, and 
unreduced font. The application must be submitted unstapled and 
unbound.
    Part A: Developing State Capacity to Address Asthma. Include each 
of the following sections:
1. Description of Problem
    Describe what is known of the asthma problem in the State or 
jurisdiction and efforts, to date, to begin to systematically address 
the problem. Describe the barriers that need to be addressed in the 
development of a comprehensive asthma program in the State. Describe 
how the agency as a whole will focus its efforts on asthma. If the 
applicant seeks funds for the occupational asthma component, describe 
the plan and justify its need.
2. Collaborative Relationships
    Describe experiences with collaborative relationships around asthma 
or with other chronic or environmentally related or work-related 
disease problems requiring extensive collaborative relationships both 
within and outside the agency.
    Specifically define the approach to be used to establish or further 
develop these relationships. Documentation of partnerships with the 
clinical community is essential, including the applicant's plan for 
working with local health agencies, physician organizations and 
community health centers. In addition, applicants should document their 
plan to work with their State chapter of the American Lung Association, 
local education authorities, and groups or organizations that serve 
minority or other populations experiencing a disproportionate burden of 
asthma. If one or more of these partners will not be included, the 
applicant should explain why.
    Letters of commitment from specific organizations, including a 
statement of their intention to collaborate, will considerably 
strengthen the application. Note that grant funds should be used to 
leverage asthma program development in the State/territory/tribe along 
with resources from other collaborative agencies and organizations.
3. Planning and Evaluating Processes
    For those States/territories/tribes without an existing asthma 
plan, describe the process by which the plan will be developed. Include 
information about the agencies and organizations that will be included 
in the planning process. Include a description about how the 
collaborative relationship will be used when the agency has a plan in 
place and is ready to implement interventions. The plan must address 
all persons with asthma in the State regardless of age, race/ethnicity 
or gender. Include a discussion of the place of occupational and work-
related asthma in the plan if funds are requested for that component.
    If a State asthma plan already exists, describe the portion of the 
plan to be implemented with these grant funds.
    Provide specific objectives for the proposed activities that are 
realistic, time-phased, and measurable and reflect the three-year 
period of this announcement. Describe how progress made toward meeting 
objectives will be evaluated and documented.
4. Surveillance System
    The applicant should include a surveillance system plan containing: 
(a) A description of data currently available to the program; (b) the 
data the agency will obtain; (c) plans for identifying at-risk 
populations (e.g., ethnic groups, socio-economic groups, and/or 
geographic areas); (d) how the agency will use this data to develop 
ongoing surveillance; and (e) how the surveillance data will be used to 
support policy development, program planning and evaluation activities.
    Participants funded under this announcement will be expected to use 
the Behavioral Risk Factor Surveillance System (BRFSS) supplemental 
asthma module at the first available opportunity, preferably within the 
first year of the project.
5. Management and Staffing Plan
    Describe the qualifications and roles of the trained public health 
professionals to serve as: an asthma coordinator for the agency's 
program and to manage the planning process and conduct other 
programmatic activities; an epidemiologist, at least 0.5 FTE, to 
develop and implement surveillance activities for the asthma project; 
and a supervisor who will assure support for the project staff. Other 
support positions may also be proposed.
    Include a plan to expedite filling of the staff position(s) and 
assure that they have been or will be approved by the applicant's 
personnel system. Where current staff already fill these roles and 
federal resources are not to be used for their support, information on 
the position and qualification of the person filling the position 
should be provided.
    Describe the organizational location of the proposed staff, their 
relation to the State's ``asthma contact'' (the position in the agency 
currently responsible for contact with CDC on asthma issues), and the 
support within the organizational structure for the activities defined 
for the project staff. Include an organizational chart for the unit in 
which the activity will be located and, at a minimum, the next two 
levels above it.
    For each position describe the primary roles and responsibilities 
for the project staff over the three-year grant period. Also, include 
the specific staff

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activities that will contribute to meeting each objective.
6. Budget
    This section must include a detailed first-year budget and 
narrative justification and future annual projections. The applicant 
should describe the program purpose for each budget item. For contracts 
contained within the application budget, applicants should name the 
contractor, if known; describe the services to be performed; justify 
the use of a third party; and provide a breakdown or a justification 
for the estimated costs of the contracts, the kinds of organizations or 
parties to be selected, the period of performance, and the method of 
selection. The budget should include travel for project staff to meet 
once per year with CDC and other grantees. Any requested funds for an 
occupational component must be presented separately, with the same 
level of detail, immediately following the main budget narrative 
justification.

Part B: Implementation of State Asthma Plans

    Include each of the following sections:
1. Description of Problem
    Describe what is known of the asthma problem in the State or 
jurisdiction. Include a description of populations at increased risk of 
poorly controlled asthma within the jurisdiction (e.g., ethnic groups, 
socio-economic groups, geographic areas). Attach published surveillance 
reports that describe asthma within the jurisdiction including a report 
on asthma in the Medicaid population.
2. Asthma Plan
    Provide the existing asthma plan as an attachment. Describe how the 
asthma plan and the plan's implementation strategy were developed, 
including a list of the partners participating in the process (if not 
part of the published plan) and support for the final plan as 
demonstrated by a letter from the Agency's Health or Medical Director 
and from key partners (e.g., the Director of the State/territorial 
American Lung Association and key professional societies). Attach a 
copy of the final plan. The final plan (or attachments to that plan) 
must include: (a) an assessment of the asthma burden in the State/
tribe/territory using population-based data; (b) measurable objectives 
that address people with asthma across the State/territory/tribe and 
include people with asthma of all ages, race/ethnic groups, and gender; 
(c) a description of how the plan's implementation would reach all 
persons with asthma in the State regardless of age, race/ethnicity, or 
gender, (d) proposed strategies to meet the plan's objectives, 
including, but not limited to, efforts to (d.1) expand surveillance for 
asthma, (d.2) improve provider compliance with the National Asthma 
Education and Prevention Program's ``Guidelines on the Diagnosis and 
Management of Asthma,'' (Guidelines for the Diagnosis and Management of 
Asthma. National Institutes of Health, National Heart, Lung, and Blood 
Institute. NIH Publication No. 97-4051, April 1997), (d.3) improve the 
skills of patients and families affected by asthma to manage the 
disease, and (d.4) evaluate the program's implementation and measure 
progress toward objectives; and (e) an assessment of existing and 
needed resources to implement these strategies.
3. Partnership Oversight
    Describe how the partners who developed the asthma plan will 
continue to implement and monitor the intervention activity and modify 
the plan over time.
4. Surveillance and Evaluation
    Describe the surveillance system currently in place within the 
health agency and its ability to support the evaluation of intervention 
activities and a continued planning process. All asthma indicators 
assessed over time should be noted (including, but not limited to, 
prevalence, mortality, hospitalization, emergency care and measures of 
disease management status), and a copy of all asthma surveillance 
reports, brochures, or publications should be provided. If available, 
analyses of Medicaid data on persons with asthma should be provided. 
Ability to provide measurement of progress in meeting all plan 
objectives should be addressed. Intentions to use BRFSS asthma 
module(s) and the frequency of use should be included; also, plans for 
further development of the asthma surveillance activity should be 
presented in detail. Surveillance of occupational asthma is encouraged 
and must be discussed.
5. Implementation of the Asthma Plan
    a. Identify the specific objectives of the asthma plan that are to 
be focused upon and the specific intervention strategies from the plan 
to be implemented that will use the resources provided through this 
announcement. Interventions that change systems and individuals to 
provide improved disease management or education are preferred. Provide 
specific realistic, measurable, and time-phased process objectives for 
each of the strategies and interventions to be implemented that reflect 
the five year period of this announcement. Describe how both process 
and outcome objectives for all activities will be evaluated and 
documented.
    b. Demonstrate the scientific basis for proposed interventions. If 
proposed interventions include case management programs, assure that 
patients enrolled are those with moderate to severe persistent asthma 
and are receiving care consistent with the National Asthma Education 
and Prevention Program (NAEPP) Clinical Practice Guidelines (Guidelines 
for the Diagnosis and Management of Asthma. National Institutes of 
Health, National Heart, Lung, and Blood Institute. NIH Publication No. 
97-4051, April 1997). Explain how it was decided by members of the 
statewide partnership group that these particular objectives and 
strategies will be addressed.
    c. Describe what objectives and strategies from the plan are 
currently being addressed utilizing other resources.
    d. Demonstrate that the plan addresses asthma in persons of all 
ages, race/ethnic groups, and gender and includes key environments in 
which persons with asthma spend significant time (e.g., home, school, 
workplace). Include a discussion on the place of occupational asthma in 
the plan.
    e. Explain how the resources from this solicitation will be 
utilized to leverage additional resources for implementation of other 
components of the plan. Explain how interventions will be 
institutionalized and sustained without these funds.
6. Management and Staffing for Intervention Activities
    a. Describe existing asthma program staff within the health 
department and their management structure, the current function of the 
asthma staff, and their role in this project plan. If plan 
implementation will be coordinated from an office other than within the 
health department, describe that office and its staff, the oversight of 
that office and its staff, and the ties of that office to the health 
agency. Provide an organizational chart for the health agency that 
identifies the unit(s) in and out of the health agency that will 
participate in the proposed activities.
    b. Describe asthma surveillance staff and their role within the 
project activities. Describe all staff who will be responsible for 
oversight of program evaluation.

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    c. If intervention activities will be implemented through 
contracts, define the process by which these contracts will be awarded 
and monitored.
    d. Describe staff available or to be hired for those aspects of the 
plan to be implemented with these resources. For each position, 
describe the primary roles and responsibilities over the five-year 
grant period.
    e. Include the specific staff activities that will contribute to 
meeting each objective that is to be addressed. Discuss the role of the 
statewide partnership group in oversight of intervention activities
    f. Document assurance of ability of key project staff to travel to 
Atlanta to participate in the CDC National Asthma Conference and/or 
grantee meetings and willingness to share innovations, information, 
data and materials.
7. Budget
    This section must include a detailed first-year budget and 
narrative justification and future annual projections. The applicant 
should describe the program purpose for each budget item. For contracts 
contained within the application budget, applicants should name the 
contractor, if known; describe the services to be performed; justify 
the use of a third party; and provide a breakdown or a justification 
for the estimated costs of the contracts, the kinds of organizations or 
parties to be selected, the period of performance, and the method of 
selection. The budget should include travel for key project staff to 
meet once per year with CDC and other grantees. This section should 
also include a listing of other funds, outside the cooperative 
agreement, that will be used to support this intervention.

F. Submission and Deadline

Letter of Intent (LOI)

    On or before July 19, 2001, submit the LOI to the Grants Management 
Specialist identified in the ``Where to Obtain Additional Information'' 
section of this announcement.
    Submit the original and two copies of PHS 5161-1 (OMB Number 0920-
0428). Forms are available in the application kit at the following 
Internet address: www.cdc.gov/od/pgo/forminfo.htm.
    On or before August 17, 2001, submit the application to the Grants 
Management Specialist identified in the ``Where to Obtain Additional 
Information'' section of this announcement.
    Deadline: Applications shall be considered as meeting the deadline 
if they are either:
    1. Received on or before the deadline date; or
    2. 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.)
    Late: Applications which do not meet the criteria in 1. or 2. above 
will be returned to the applicant.

G. Evaluation Criteria

    Each application will be evaluated individually against the 
following criteria by an independent review group appointed by CDC.

Part A: Developing State Capacity to Address Asthma

1. Description of the problem (10 points)
    The extent to which the agency's commitment to addressing asthma is 
demonstrated by accomplishments to date in understanding the problem.
2. Collaborative Relationships (20 points)
    The demonstration and description of prior successful 
collaborations to address asthma or other chronic or environmentally 
related or occupationally-related problems. The appropriateness of 
organizations and agencies identified. The level of commitment of key 
organizations as demonstrated by the content of the letters of 
commitment.
3. Planning and Evaluating Processes (35 points)
    For those applicants without an existing asthma plan, the 
appropriateness of the planning and implementation process proposed. 
The extent to which objectives are consistent with the stated purpose 
of the announcement are measurable, time-phased and the ability of the 
applicant to meet the objectives according to the specified time table. 
The adequacy of the applicant's plan to monitor progress toward meeting 
the stated objectives.
4. Surveillance System Plan (15 points)
    The extent to which the description of the surveillance system 
includes all elements outlined in the application content section and 
the quality and extent of submitted surveillance reports.
5. Management and Staffing Plan (20 points)
    The extent to which the role of proposed staff is defined and the 
agency has identified adequate qualifications of and level of 
commitment for the proposed staff; and the level of organizational 
support available to the project staff.
6. Budget (not scored)
    The extent to which the budget is reasonable, adequately justified 
and consistent with the intended use of the cooperative agreement 
funds.

Part B: Implementation of State Asthma Plans

1. Description of the Problem (5 points)
    The extent to which the agency's commitment to addressing asthma is 
demonstrated by accomplishments to date in understanding the problem. 
The extent to which the agency has been able to identify populations at 
increased risk and effectively disseminate and use that information in 
the planning process.
2. Asthma Plan (20 points)
    The extent to which a wide variety of appropriate partners were 
engaged to develop the plan; the commitment by the Agency to the 
implementation of this plan as demonstrated by the inclusion of a 
letter of support from the Secretary of Health or the Agency's Medical 
Director; the extent to which the intervention plan is supported in the 
community by the inclusion of letters of support from key members of 
the community; the extent to which the asthma plan is comprehensive and 
includes the items listed in the application section for this 
announcement.
3. Partnership Oversight (10 points)
    The extent to which appropriate partners will be a part of the 
implementation and oversight of the implementation.
4. Surveillance and Evaluation (20 points)
    The current state of the surveillance system; the quality of 
surveillance reports provided; the ability to provide measurement of 
progress in meeting all plan objectives; the plan for appropriate 
continued development of the asthma surveillance activity. The ability 
to support evaluation of implementation activities.
5. Implementation of the Asthma Plan (30 points)
    Clear link between the plan and the proposed implementation; the 
appropriateness and scientific support for the proposed implementation; 
the involvement of statewide partners in development of the proposed

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implementation and its monitoring over time; the use of these resources 
to leverage additional resources for plan implementation; the plans to 
institutionalize specific interventions; specific objectives that are 
realistic, measurable and time phased; clear definition of both process 
and outcome measures for the evaluation of implementation activities.
6. Management and Staffing for Intervention Activities (15 points)
    The current functioning of asthma staff (program and surveillance) 
within the health agency; the description of staff to be hired or 
contracts to be developed; the link of staff to program objectives; the 
continued role of the statewide partnership group. Assurance that key 
personnel will attend scheduled grantee meetings and CDC-sponsored 
national asthma conferences, and that the applicant agrees to share 
innovations, information, data and materials.
7. Budget (Not scored)
    The extent to which the budget is reasonable, adequately justified 
and consistent with the intended use of the cooperative agreement 
funds.

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 and performance reports, no more than 90 days 
after the end of the project period.
    Send all reports to the Grants Management Specialist identified in 
the ``Where to Obtain Additional Information'' section of this 
announcement.
    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment 2 of the 
announcement in the application kit.

AR-7 Executive Order 12372 Review
AR-10 Smoke-Free Workplace Requirements
AR-11 Healthy People 2010
AR-12 Lobbying Restrictions

I. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under sections 301 and 317 of the Public 
Health Service Act, [42 U.S.C. section 241 and 247b], as amended. The 
Catalog of Federal Domestic Assistance number is 93.283.

J. Where to Obtain Additional Information

    This and other CDC announcements can be found on the CDC home page 
Internet address http://www.cdc.gov Click on ``Funding'' then ``Grants 
and Cooperative Agreements.''
    To obtain business management technical assistance, contact: Sonia 
Rowell, Grants Management Specialist, Grants Management Branch, 
Procurement and Grants Office, Centers for Disease Control and 
Prevention, 2920 Brandywine Road, Room 3000, Atlanta, GA 30341-4146, 
Telephone number: (770) 488-2724, Email address: [email protected].
    For program technical assistance, contact: Leslie P. Boss, Air 
Pollution and Respiratory Health Branch, National Center for 
Environmental Health, Centers for Disease Control and Prevention, 
Mailstop E-17, 1600 Clifton Rd., NE, Atlanta, GA 30333, Telephone 
number: (404) 498-1002, Email address: [email protected].

    Dated: June 14, 2001.
John L. Williams,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention (CDC).
[FR Doc. 01-15476 Filed 6-19-01; 8:45 am]
BILLING CODE 4163-18-P