[Federal Register Volume 67, Number 80 (Thursday, April 25, 2002)]
[Notices]
[Pages 20536-20539]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-10088]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Special Projects of National Significance, Targeted Information 
Technology Model Implementation; Evaluation and Technical Assistance 
Center

AGENCY: Health Resources and Services Administration and Agency for 
Healthcare Research and Quality, HHS.

ACTION: Notice of availability of funds.

-----------------------------------------------------------------------

SUMMARY: The Health Resources and Services Administration (HRSA) and 
the Agency for Healthcare Research and Quality (AHRQ) announce the 
availability of fiscal year (FY) 2002 funds to be awarded under the 
Special Projects of National Significance (SPNS) program for 
discretionary grants, under a new competition that supports the 
evaluation of the effectiveness of Information Technology (IT) to 
improve the delivery and quality of care to underserved HIV-infected 
individuals. The purpose of this new grant initiative is to support 
multi-year projects that will develop and evaluate IT-based projects 
that: (1) Optimize the delivery of health care; (2) optimize outcomes 
and quality of health care; and (3) assess the cost-effectiveness of IT 
interventions. In addition, a Technical Assistance (TA) Center will be 
supported to provide advice and

[[Page 20537]]

technical assistance to the funded multi-year IT Projects regarding 
program refinement and evaluation. Special emphasis is directed to help 
individuals from communities of color and underserved populations.
    The SPNS program is authorized by section 2691 of the Public Health 
Service (PHS) Act.
    Funds will be awarded in two categories. In the first category (IT 
Projects), HRSA and AHRQ expect to award approximately three (3) grants 
for the development and evaluation of IT-based projects that can 
improve the delivery of primary medical care and/or ancillary services 
to underserved HIV-infected individuals. It is anticipated that each IT 
Project site will be awarded approximately $400,000 per year for a 4-
year project period.
    In the second category (TA Center), HRSA and AHRQ expect to award 
one grant up to $300,000 per year for a 4-year project period to 
support a TA Center. This TA Center will provide technical assistance 
to grantees on areas related to program implementation, evaluation, and 
dissemination of findings.
    Grants may be awarded to eligible public and private non-profit 
entities to develop and evaluate technological interventions of care 
for the treatment of people with HIV infection.
    Proposed IT Projects should seek to improve the delivery of primary 
medical care and/or ancillary services and contribute to measurable and 
sustainable improvements in three main areas: (1) Optimizing the 
delivery of health care; (2) optimizing outcomes and quality of health 
care; and (3) assessing the cost-effectiveness of IT interventions. 
Each of the areas is described below:
    Optimizing delivery of care: The first area of emphasis focuses on 
how the application of technology can facilitate and improve the 
delivery of care. This may include, but is not limited to, linking 
health care systems with other systems of care that HIV-infected 
individuals may require such as drug rehabilitation programs, mental 
health care, and other social services.
    Optimizing outcomes and quality: The second area of emphasis 
focuses on how to improve outcomes and quality of care. This may 
include, but is not limited to, tools for provider decision-support in 
clinical settings or other strategies to reduce medical errors, enhance 
medication adherence, and improve clinician-prescribing practices.
    Assessing cost-effectiveness: The third area of emphasis relates to 
how the application of IT can reduce health care costs without 
adversely affecting outcomes or quality. This may include, but is not 
limited to, IT interventions that can reduce medication costs or 
decrease hospitalizations for HIV-positive patients.
    IT Projects should focus on under-served populations and be 
evaluated in outpatient or community-based settings. Grantees are 
expected to select the evaluative framework and instruments within six 
(6) months and have the IT-based intervention up and running within 
nine (9) months. The intervention may utilize an IT tool already in use 
or adapt an IT tool within the first nine (9) months of award. If tools 
must be adapted, applicants are encouraged to partner with a technology 
vendor or University-based technology program. IT Project grantees are 
expected to collaborate with the SPNS-supported TA Center and widely 
disseminate results of the project. The TA center will facilitate the 
evaluation and dissemination efforts of the successful IT projects.
    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 IT-based 
demonstration models will include, among other factors, the degree to 
which the applicant's plan improves the delivery, quality or cost-
effectiveness of care for vulnerable subpopulations and historically 
under-served communities by implementing innovative IT-based 
interventions.

DATES: To help HRSA adequately plan for the Objective Review Process, 
Letters of Intent are encouraged from all applicants. Such letters 
should be sent to: Barbara Aranda-Naranjo, PhD, RN, FAAN, Branch Chief, 
ATTN: 2002 IT Initiative, Demonstration Project Development and 
Evaluation Branch, Office of Science and Epidemiology, HIV/AIDS Bureau, 
Health Resources and Services Administration, 5600 Fishers Lane, Rm. 
7C-07, 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.

EFFECTIVE DATE: Applications must be received in the HRSA Grant 
Application Center by the close of business June 12, 2002, 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 received after the deadline will be 
returned to the applicant.

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; 2002 IT Initiative, The Legin Group, Inc., 
901 Russell Avenue, Suite 450, Gaithersburg, MD 20879; 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) Web site: http://www.psc.gov/forms/PHS/phs.html. All applications submitted to the SPNS 
program will be reviewed and rated by an objective review panel. The 
application guidance may be accessed through HRSA's Web site at 
www.hrsa.dhhs.gov/grants.htm.

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. Mary Douglas, Grants 
Management Specialist, HIV/AIDS Bureau, Health Resources and Services 
Administration, 5600 Fishers Lane, Rm. 7-89, Rockville, MD 20857; 
telephone 301-443-1262; fax 301-594-6096; e-mail address: 
[email protected].
    Additional information regarding program issues and the overall 
SPNS Program may be requested from Barbara Aranda-Naranjo, PhD, RN, 
FAAN, Branch Chief, ATTN: 2002 IT Initiative, Demonstration Project 
Development and Evaluation Branch, Office of Science and Epidemiology, 
HIV/AIDS Bureau, Health Resources and Services Administration, 5600 
Fishers Lane, Rm. 7C-07, Rockville, MD 20857; telephone 301-443-4149; 
fax 301-443-4965; e-mail address: [email protected].

[[Page 20538]]

    Technical assistance regarding this funding announcement may be 
requested from Rick Crane, Special Program Consultant, Demonstration 
Project and Evaluation Branch, Office of Science and Epidemiology, HIV/
AIDS Bureau, Health Resources and Services Administration, 5600 Fishers 
Lane, Room 7C-07, Rockville, MD 20857; telephone 301-443-0232; fax 415-
626-7369; 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: 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. Within the health care delivery 
system, information technology is increasingly being used to improve 
services. Rapid advances in IT now make it possible to bring 
information to both health care providers and patients. Some of these 
IT interventions include automated laboratory reporting, electronic 
medical records, computerized provider order entry, smart cards, bar 
coding and digital imaging. In addition, IT can be used for provider 
and patient education and training. While the use of information 
technology in health care continues to expand, there is little to no 
evidence demonstrating the effectiveness of IT to improve HIV care. 
This solicitation seeks proposals that will assess the extent to which 
IT applied in various HIV care settings can contribute to measurable 
and sustainable improvements in the delivery, quality or cost-
effectiveness of care for people living with HIV. Further, the 
announcement seeks applications for a TA Center to work with funded IT 
Project grantees.

Review Criteria

Criteria for the technical review of applications for IT Projects 
are as follows

    1. (20 points) Description of the applicant's organizational 
capacity and eligibility;
    2. (15 points) Description of the context for the proposed 
intervention;
    3. (25 points) Description of the applicant's current IT-based 
model and proposed intervention;
    4. (25 points) Description of evaluation and dissemination 
plans;
    5. (10 points) Appropriateness and justification of the budget; 
and
    6. (5 points) Adherence to Program Guidance.

Criteria for the technical review of applications for the TA Center 
are as follows

    1. (25 points) Description of the professional qualifications of 
personnel;
    2. (20 points) Description of the organizational capacity;
    3. (25 points) Description of a comprehensive work plan;
    4. (15 points) Description of product development activities;
    5. (10 points) Appropriateness and adequacy of the budget; and
    6. (5 points) Adherence to the Program Guidance.

Availability of Funds

    The SPNS program is authorized by Section 2691of the PHS Act. 
Grants may be awarded directly to public and non-profit private 
entities, including community-based organizations. The program has 
approximately $1.5 million dollars available for this initiative. HRSA 
expects to make approximately three (3) awards for demonstration 
projects and one award for the Technical Assistance Center. The budget 
and project periods for approved and funded projects will begin on or 
about October 1, 2002. All applicants should submit budgets for the 4-
year project period.
    All grantees funded should recognize that this initiative is not 
designed to provide continuous support once the SPNS demonstration 
project is completed and evaluated. Demonstration programs are strongly 
encouraged to secure non-SPNS funding support during their projects if 
the evaluation suggests that the model is effective and merits 
continuation. Further information on this matter is contained in the 
Guidance.

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; faith-based and 
community-based service organizations (e.g., AIDS service 
organizations, Federally-qualified health centers, family planning 
centers, AIDS anti-discrimination and advocacy organizations, homeless 
assistance providers, hemophilia centers, community mental health 
centers, substance abuse treatment centers, urban and tribal Indian 
health centers or facilities, migrant health centers, etc.), 
institutions of higher education (e.g., Historically Black Colleges and 
Universities, Hispanic Serving Institutions, and Tribal Colleges and 
Universities), and national service provider and/or policy development 
associations and organizations.

Allowable Costs

    The basis for determining allocable and allowable costs to be 
charged to PHS grants is set forth in 45 CFR part 74 and 45 CFR part 92 
for State, local, or tribal governments. The four separate sets of cost 
principles prescribed for public and private non-profit recipients are: 
OMB Circular A-87 for State, local or tribal governments; OMB Circular 
A-21 for institutions of higher education; 45 CFR part 74, Appendix E 
for hospitals; and OMB Circular A-122 for non-profit organizations. 
Further information on allowable costs is contained in the Guidance.

Reporting and Other Requirements

    A successful applicant under this notice will submit two semi-
annual activity summary reports, in accordance with provisions of the 
general regulations which apply under 45 CFR 74.51 ``Monitoring and 
Reporting of Program Performance,'' with the exception of State and 
local governments to which 45 CFR part 92 reporting requirements apply.

Federal Smoke Free Compliance

    The PHS strongly encourages all grant and contract 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 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

[[Page 20539]]

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.
    All applicants are required to submit, no later than the Federal 
due date for receipt of the application, the following information to 
the administrator of the State and local health agencies and to the 
State and local AIDS program director in the area(s) to be affected by 
the proposed program: (1) a copy of the face page of the application 
(SF 424); and, (2) a summary of the project, not to exceed one page, 
which provides: (a) A description of the population to be served; (b) a 
summary of the services to be provided; and, (c) 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 
this program.

Executive Order 12372

    The SPNS 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. Executive Order 12372 allows States the option of setting up 
a system for reviewing applications from within their States for 
assistance under certain Federal programs. The application packages to 
be made available under this notice will contain a listing of States 
which have chosen to set up a review system and will provide a State 
Single Point of Contact (SPOC) for the 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 appropriate deadline dates. HRSA 
does not guarantee that it will accommodate or explain its responses to 
State process recommendations received after the due date. (See 
``Intergovernmental Review of Federal Programs,'' Executive Order 
12372, and CFR part 100, for a description of the review process and 
requirements.)

Audit Requirements

    Applicants are required to comply with requirements of OMB Circular 
A-133. For additional information on this topic, contact Ms. Mary 
Douglas, Grants Management Specialist, HIV/AIDS Bureau, Health 
Resources and Services Administration, 5600 Fishers Lane, Rm. 7-89, 
Rockville, MD 20857; telephone 301-443-1262; fax 301-594-6096; e-mail 
address: [email protected].

    The OMB Catalog of Federal Domestic Assistance number for the 
Special Projects of National Significance is 93.928.

    Dated: April 18, 2002.
Elizabeth M. Duke,
Administrator.
[FR Doc. 02-10088 Filed 4-24-02; 8:45 am]
BILLING CODE 4165-15-P