[Federal Register Volume 67, Number 81 (Friday, April 26, 2002)]
[Notices]
[Pages 20791-20794]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-10204]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[CMS-2149-N]


Medicaid Program; Infrastructure Grants Program To Support the 
Design and Delivery of Long Term Services and Supports That Permit 
People of Any Age Who Have a Disability or Long Term Illness To Live in 
the Community

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice of funding availability for continuation of systems 
change grants awards process.

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SUMMARY: This notice announces the availability of an additional $55 
million in grant funding through our ``Systems Change Grants for 
Community Living''. The Systems Change grants include four distinct 
competitive grant opportunities: (1) Nursing Facility Transitions; (2) 
Community-integrated Personal Assistance Services and Supports; (3) 
Real Choice Systems Change; and (4) The Community Living Exchange 
Collaborative: A National Technical Assistance Program (The 
Collaborative) (formerly, The National Technical Assistance Exchange 
for Community Living). The four grants are designed to assist States in 
developing enduring systems improvements that support people of any age 
who have a disability or long-term illness to live and participate in 
their communities. These grants are a part of the President's New 
Freedom Initiative to eliminate barriers to equality and grant a ``New 
Freedom'' to children and adults of all ages who have a disability or 
long term illness so that they may live and prosper in their 
communities. This notice also contains information about the manner in 
which we will continue the award process that originally started in FY 
2001. We will not accept any new applications for Systems Change Grants 
in FY 2002.

DATES: Deadline for Submitting Response Form: Qualified Applicants (see 
``Definition of Qualified Applicants'' in section II.D. of this notice) 
who submitted an application in FY 2001, and received from us written 
notification dated March 28, 2002 of a ``preliminary award'' must 
submit the Response Form (that was enclosed with their written 
notification) no later than May 9, 2002, indicating whether they wish 
to receive an award in FY 2002.
    Deadline for Submitting Responses to Draft Terms and Conditions and 
Project Feedback of Preliminary Grant Award: Qualified Applicants must 
respond to the draft terms and conditions and project feedback of the 
preliminary grant award by July 10, 2002.

ADDRESSES: Response Form: The addresses for submitting completed 
Response Forms are listed in order by our preferred means of 
submission; they are as follows: by e-mail to [email protected], 
by facsimile to Jeremy Silanskis (410-786-9004), or by mail to Jeremy 
Silanskis, Centers for Medicare & Medicaid Services, Center for 
Medicaid and State Operations, DEHPG/DASI, Mailstop: S2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850. Applications mailed 
through the U. S. Postal Service or a commercial delivery service will 
be considered ``on time'' if received by close of business on the 
closing date, or postmarked (first class mail) by the date specified 
and received within five business days. If express, certified, or 
registered mail is used, the Qualified Applicant should obtain a 
legible dated mailing receipt from the U. S. Postal Service. Private 
metered postmarks are not acceptable as proof of timely mailings. 
Response Forms that do not meet the above criteria will be considered 
late.
    Qualified Applicants who wish to obtain an electronic copy of the 
Response Form or have questions regarding the Response Form, please 
contact Jeremy Silanskis at: 410-786-1592; or by e-mail to 
[email protected].
    Response to Draft Grant Terms and Conditions and Project Feedback: 
We will include with the draft grant terms and conditions and requests 
for project feedback that we send to the Qualified Applicants the name, 
address, and phone number of the CMS project officer to whom the 
responses to the draft grant terms and conditions must be submitted.
    Web Site: To obtain additional information about the Systems Change 
grants, please visit our web site at: 
http://www.hcfa.gov/medicaid/systemschange/default.htm.

FOR FURTHER INFORMATION CONTACT: Questions about the Systems Change 
grants may be directed to: Mary Guy, Centers for Medicare & Medicaid 
Services, Center for Medicaid and State Operations, DEHPG/DASI, Mail 
Stop: S2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850, 
(410) 786-2772; or by e-mail to: [email protected].

SUPPLEMENTARY INFORMATION:   

I. Background

A. General

    People of all ages who have a disability or long-term illness 
generally express the same desire to live in the community, as do most 
other Americans. They express a desire to live in their own homes, make 
their own decisions about daily activities, work, learn, and maintain 
important social relationships. They express a desire to contribute and 
participate in their communities and family life.
    In 1990, the Congress enacted the Americans with Disabilities Act 
(ADA) (Pub. L. 101-336). The ADA recognized that ``society has tended 
to isolate and segregate individuals with disabilities, and, despite 
some improvements, such forms of discrimination against individuals 
with disabilities continue to be a serious and pervasive social 
problem'' (42 U.S.C. 12101(a)(2)). The ADA gave legal expression to the 
desires and rights of Americans to lead lives as valued members of 
their own communities despite the presence of disability.
    Over the past few years, a consensus for assertive new steps to 
improve the capacity of our long-term support systems to respond to the 
desires of our citizenry has been building. Federal, State, and local 
governments have begun to take actions to renew and reaffirm a 
commitment to improving the systems that will support people of all 
ages with disabilities or long-term illnesses who wish to live in their 
communities. The President invigorated these efforts in 2001 through 
his New Freedom Initiative and Executive Order 13217. The Executive 
Order directs

[[Page 20792]]

Federal agencies to provide assistance to States and to identify 
federal policy barriers that might be removed in order to achieve 
fulfillment of the ADA. For additional information about the New 
Freedom Initiative and Executive Order 13217, please visit the web site 
at: 
http://www.whitehouse.gov.

B. FY 2001 Systems Change Grants for Community Living

    On May 22, 2001, we published a Notice of Funding Availability for 
the Systems Change Grants for Community Living in the Federal Register 
(66 FR 28183). Under this notice, we invited proposals from States and 
others, in partnership with their disability and aging communities, to 
design and implement effective and enduring improvements in community 
long term support systems. Grant applications were due in July 2001. 
The response of States, and other eligible entities, to these grant 
opportunities was extraordinary. The response revealed a strong 
interest on the part of States and their citizens to improve their 
community-based systems, and a vital role for federal technical and 
resource assistance. We received 161 applications for these Systems 
Change grants from 51 States and Territories (48 States, the District 
of Columbia, and 2 Territories) requesting funding totaling 
approximately $240 million.
    In September 2001, we announced the award of grants in 37 States 
and one territory totaling approximately $70 million. In FY 2001, we 
awarded: 25 Real Choice Systems Change grants; 10 Community-integrated 
Personal Assistance Services and Supports grants; 12 Nursing Facility 
Transitions, State Program Grants; and 5 Nursing Facility Transitions, 
Independent Living Partnership grants. In FY 2001, we also awarded two 
grants for the National Technical Assistance Exchange for Community 
Living. For further information on the selection process of the grants 
awarded in FY 2001, please see our web site at: http://www.hcfa.gov/medicaid/systemschange/selproc.pdf. In addition, the solicitation from 
FY 2001 is available at: http://www.hcfa.gov/medicaid/systemschange/backgrnd.htm.
    Due to the extraordinary response we received in FY 2001 to the 
Systems Change Grants for Community Living solicitation, we will not 
accept any new applications in FY 2002. Instead, we will continue to 
process the ranked applications submitted in 2001, beginning with the 
highest-ranked applications that were not funded in FY 2001. On March 
28, 2002, we sent a notice of preliminary award and a Response Form to 
those Qualified Applicants, as explained below. We will also furnish 
draft grant terms and conditions (including project feedback) to those 
Qualified Applicants. (See section II.B. of this document for 
additional information on ``Requirements to Receive Notice of Grant 
Award''.)

II. Overview of FY 2002 Systems Change Grants Award Process

    In FY 2002, the Congress appropriated an additional $55 million in 
funds for these Systems Change grants specifically to improve 
community-integrated services (Departments of Labor, Health and Human 
Services, and Education, and Related Agencies Appropriations Act, 2002 
Pub. L. 107-116). In a Press Release dated March 25, 2002, the 
Secretary announced that these funds will enable the Department to help 
States improve community-based services. (To review this Press Release, 
please visit: http://www.hhs.gov/news/press/2002pres/20020325a.html.)
    Since we received far more applications in FY 2001 than we were 
able to fund, we are announcing our intention to continue the award 
process for Qualified Applicants. (See section ``II.D. Definition of 
Qualified Applicants'' of this notice.) We have used the review panel 
scores from FY 2001, to determine the ranking of all applications in 
each grant category. We will attempt to provide funding for 
applications where funding was previously unavailable. In addition, we 
reserve the right to make ``supplemental'' awards in FY 2002 to certain 
States or other eligible entities that received awards in FY 2001; 
these ``supplemental'' awards will ensure fair treatment between 
Grantees awarded funds in FY 2001 and 2002 while ensuring that the 
purposes of these grants are met. In the event that we received more 
than one application for any grant solicitation for which the ``one per 
State'' standard applies, we reserve the right to select which 
application will be considered for funding. We also reserve the right 
to ensure reasonable balance in awarding grants in FY 2002, in terms of 
key factors (such as geographic distribution and broad target group 
representation) as noted in the FY 2001 grant solicitation.
    We reserve the right to reallocate those funds to the next highest-
ranked Qualified Applicant(s) or to supplement entities that previously 
received funding, if Qualified Applicants are subsequently determined 
not to have met all of the requirements of our May 22, 2001 Notice of 
Funding Availability (66 FR 28183), the grant terms and conditions, or 
otherwise fail to submit a Response Form to us by the date indicated 
above.
    We have determined that we will be able to fund in FY 2002 
approximately: 25 new Real Choice Systems Change grants; 8 new 
Community-integrated Personal Assistance Services and Supports grants; 
11 new Nursing Facility Transitions, State Program grants; and 5 new 
Nursing Facility Transitions, Independent Living Partnership grants. We 
will also attempt to make supplemental awards to the two Grantees for 
the Community Living Exchange Collaborative: A National Technical 
Assistance Program. Additionally, we will attempt to make supplemental 
awards to 5 States that received Real Choice Systems Change grants in 
FY 2001 to ensure that these 5 Grantees are not disadvantaged in the 
amount of the award received as compared to States receiving awards in 
FY 2002. (See ``Chart 1--Qualified Applicants for FY 2002 Systems 
Change Grants and Amount of Preliminary Awards''). We anticipate that 
these grants will be officially awarded on or before September 30, 
2002. (See ``Chart 2--Key Dates for 2002 Systems Change Grants 
Process''.) We will notify, in writing, the Qualified Applicants 
described above of this award process.

A. Timing and Duration of Awards

    We expect all Notice of Grant Awards to be made on or before 
September 30, 2002. New Grantees may expend grant funds over a 36-month 
period from the date of the award. Existing Grantees receiving 
``supplemental awards'' will be able to use the ``supplemental award'' 
during the existing 36-month budget period of their original grants.

B. Requirements To Receive Notice of Grant Award

    Qualified Applicants before receiving an official Notice of Grant 
Award (Form CMS 6-U6-PG (9-84)) will receive draft grant terms and 
conditions of the proposed award. These draft grant terms and 
conditions will contain criteria the entity must meet and will specify 
any additional information required. These draft grant terms and 
conditions will ask Qualified Applicants, among other things, to 
provide us with: (1) An updated budget and budget narrative reflecting 
the amount of proposed award; (2) an updated proposed project abstract 
and abbreviated project narrative describing the project's goals, 
activities and expected outcomes, given the proposed amount of funding; 
and (3) a description, in the abbreviated narrative, of how people with

[[Page 20793]]

disabilities and long-term illnesses and their representatives will be 
involved in all stages of planning, implementation, monitoring and 
evaluation activities for the proposed project. The deadline for 
submission of this information is noted in ``Chart 2--Key Dates for 
2002 Systems Change Grants Process''. These dates will also be posted 
on the CMS Systems Change web site at: http://www.hcfa.gov/medicaid/systemschange/default.htm.
    Specific requirements of Grantees, including the non-financial 
recipient contribution, as stated in the Notice of Funding 
Availability, dated May 22, 2001 (66 FR 28183) will continue to apply 
to all Qualified Applicants that receive awards in FY 2002.

C. Indirect Costs

    Reimbursement of indirect costs under each of the four types of 
grants is governed by the provisions of the U. S. Department of Health 
and Human Services, Grants Policy Directive (GPD) Part 3.01: Post-
Award--Indirect Costs and Other Cost Policies. We recommend that 
Qualified Applicants review the provisions of this policy directive and 
applicable Office of Management and Budget (OMB) circulars in preparing 
budget information. This information is available in the solicitation 
and online at: http://www.hhs.gov/grantsnet/adminis/gpd/gpd301.htm.

D. Definition of Qualified Applicants

    We will not accept any new applications in FY 2002, due to the 
extraordinary number of unfunded applications received in FY 2001. 
Instead, we will continue to process the ranked applications submitted 
in 2001, beginning with the highest-ranked applications that were not 
funded in FY 2001. We have offered funding to those Qualified 
Applicants. Qualified Applicants are those Applicants who (1) submitted 
an application in FY 2001 and (2) received from us written notification 
dated March 28, 2002 of a ``preliminary'' award indicating that their 
application received a score from the review panel in a range that will 
permit us to make a ``preliminary'' award in FY 2002. Additional 
information on the award process is available in section II (Overview 
of FY 2002 Systems Change Grant Award Process). Through our technical 
assistance efforts, we will continue to work with all States and 
Territories, as well as other non-Grantees, to improve community-
integrated long term services and supports.

E. Involvement of Consumers, Stakeholders, and Public-Private 
Partnerships

    For all Qualified Applicants, we expect continuous and active 
involvement of consumers in project design, implementation, and 
evaluation. We encourage processes that promote the active involvement 
of all other stakeholders. In addition, we encourage the development of 
public-private partnerships that make the most effective use of each 
partner's expertise.
    For the FY 2001 and FY 2002 Real Choice Systems Change grants, the 
Congress expressed its preference that the grant applications ``be 
developed jointly by the State and the Consumer Task Force'' (H. Conf. 
Rep. No. 106-1033 at 150 and H. Conf. Rep. No. 107-342 at 101, adopting 
S. Rep. No. 107-84 at 17). The task force should be composed of 
individuals with disabilities from diverse backgrounds (including the 
elderly), representatives from organizations that provide services to 
individuals with disabilities, consumers of long-term services and 
supports, and those who advocate on behalf of such individuals (H. 
Conf. Rep. No. 106-1033 at 150 and H. Conf. Rep. No. 107-342 at 101, 
adopting S. Rep. No. 107-84 at 17). Each Qualified Applicant is 
encouraged to continue to involve its task force in the process of 
developing a response to the draft grant terms and conditions.
    We encourage collaboration with public-private partnerships and 
with a broad range of public and private organizations whose primary 
purpose is improving access and services for people with disabilities 
or long-term illnesses. Examples of these organizations include State 
Independent Living Councils, Area Agencies on Aging, Developmental 
Disabilities Councils, State Mental Health Planning Councils, State 
Assistive Technology Act Projects, and other national and statewide 
consumer, disability and aging organizations. We also encourage 
Qualified Applicants to partner with volunteer groups, employers, 
faith-based service providers, private philanthropic organizations, and 
other community-based organizations.

F. Executive Order 12372

    Applications for these grants are not subject to review by States 
under Executive Order 12372, ``Intergovernmental Review of Federal 
Programs'' (45 CFR part 100).

G. Information Collection Requirements

    The information collection requirements associated with the Notice 
of Funding Availability published on May 22, 2001 (66 FR 28183) have 
been reviewed and approved by the Office of Management and Budget (OMB 
No.: 0938-0836 Expiration Date: 02/28/2005).

    Authority: These grants are authorized under section 1110 of the 
Social Security Act. Funding and direction from the Congress was 
provided in the Departments of Labor, Health and Human Services, and 
Education and Related Appropriation Bill, for FY 2002, Pub. L. 107-
116, and in the accompanying Report, H. Conf. Rep. No. 107-342 at 
101. In addition, funding and Congressional language was provided in 
the Consolidated Appropriations Act, 2001 (Pub. L. 106-554) 
(including H.R. 5656 Labor, HHS, and Education Appropriations), and 
in the accompanying Report, H. Conf. Rep. No. 106-1033. CMS is the 
designated HHS agency with administrative responsibility for this 
grant program. (Catalog of Federal Domestic Assistance Number: 
93.779; Research and Demonstrations)

    Dated: April 1, 2002.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.

Addendum 1--Qualified Applicants for FY 2002 Systems Change Grants 
and Amount of Preliminary Awards

I. New Awards

    Below are the States/Eligible Entities that were offered new awards 
as described in section II of this notice.

   Chart 1.--Qualified Applicants--FY 2002 Real Choice Systems Change
                                 Grants
------------------------------------------------------------------------
                                                             Amount of
                  State/eligible entity                     preliminary
                                                               award
------------------------------------------------------------------------
Alaska..................................................      $1,385,000
California..............................................       1,385,000
Colorado................................................       1,120,147
Commonwealth of Northern Mariana Islands................       1,385,000
Connecticut.............................................       1,385,000
District of Columbia....................................       1,385,000
Georgia.................................................       1,385,000
Indiana.................................................       1,385,000
Kansas..................................................       1,385,000
Louisiana...............................................       1,385,000
Mississippi.............................................       1,385,000
Montana.................................................       1,385,000
New Mexico..............................................       1,385,000
Nevada..................................................       1,385,000
New York................................................       1,385,000
North Dakota............................................         900,000
Ohio....................................................       1,385,000
Oklahoma................................................       1,385,000
Pennsylvania............................................       1,385,000
Rhode Island............................................       1,385,000
Texas...................................................       1,385,000
Utah....................................................       1,385,000
Washington..............................................       1,385,000
Wisconsin...............................................       1,385,000
West Virginia...........................................       1,313,996
------------------------------------------------------------------------


[[Page 20794]]


  Chart 2.--Qualified Applicants--FY 2002 Community-Integrated Personal
                 Assistance Services and Supports Grants
------------------------------------------------------------------------
                                                             Amount of
                  State/eligible entity                     preliminary
                                                               award
------------------------------------------------------------------------
Colorado................................................        $725,000
District of Columbia....................................         725,000
Hawaii..................................................         725,000
Indiana.................................................         725,000
Kansas..................................................         725,000
North Carolina..........................................         725,000
Tennessee...............................................         725,000
West Virginia...........................................         725,000
------------------------------------------------------------------------


  Chart 3.--Qualified Applicants--FY 2002 Nursing Facility Transitions,
                          State Program Grants
------------------------------------------------------------------------
                                                             Amount of
                  State/eligible entity                     preliminary
                                                               award
------------------------------------------------------------------------
Alabama.................................................        $770,000
Arkansas................................................         598,444
California..............................................         600,000
Delaware................................................         566,772
Nebraska................................................         600,000
New Jersey..............................................         600,000
North Carolina..........................................         600,000
Ohio....................................................         600,000
Rhode Island............................................         600,000
South Carolina..........................................         600,000
Wyoming.................................................         600,000
------------------------------------------------------------------------


  Chart 4.--Qualified Applicants--FY 2002 Nursing Facility Transitions,
                  Independent Living Partnership Grants
------------------------------------------------------------------------
                                                              Amount of
   State/ eligible  entity             Organization          preliminary
                                                                award
------------------------------------------------------------------------
California...................  Community Resources for           337,500
                                Independence.
Minnesota....................  Metropolitan Center for           400,000
                                Independent Living.
Delaware.....................  Independent Resources, Inc.       270,000
New Jersey...................  Resources for Independent         400,000
                                Living, Inc.
Utah.........................  Utah Independent Living           400,000
                                Center.
------------------------------------------------------------------------

II. Supplemental Awards

    Below are the States/Eligible Entities that were offered 
supplemental awards as described in section II of this notice.

   Chart 1.--Qualified Applicants--FY 2002 Real Choice Systems Change
                                 Grants
------------------------------------------------------------------------
                                                   Amount     Amount of
            State/ eligible  entity              awarded FY  preliminary
                                                    2001        award
------------------------------------------------------------------------
Maryland......................................   $1,025,000     $360,000
Arkansas......................................    1,025,000      360,000
Massachusetts.................................    1,025,000      360,000
Virginia......................................    1,025,000      360,000
Iowa..........................................    1,025,000      360,000
------------------------------------------------------------------------


  Chart 2.--Qualified Applicants--FY 2002 The Community Living Exchange
         Collaborative: A National Technical Assistance Program
------------------------------------------------------------------------
                                                              Amount of
       Organization/ eligible  entity          Amount  FY    preliminary
                                               2001  award      award
------------------------------------------------------------------------
Rutgers Center for State Health Policy......    $2,435,621    $1,886,500
ILRU `` Independent Living Research              2,435,621     1,886,500
 Utilization................................
------------------------------------------------------------------------

Addendum 2--Key Dates for 2002 Systems Change Grants Process

------------------------------------------------------------------------
                Date(s)                               Action
------------------------------------------------------------------------
May 9, 2002............................  Response Form is due from
                                          Qualified Applicants.
March 22-July 9, 2002..................  Qualified Applicants partner
                                          with consumer advisory groups
                                          and stakeholders to do the
                                          following:
                                          Reprioritize proposed
                                          grant projects based on
                                          revised budgets;
                                          Reconsider proposed
                                          budget based on amount of
                                          preliminary award; and
                                          Respond to draft grant
                                          terms and conditions of award
                                          and requests for feedback.
July 10, 2002..........................  Deadline for Qualified
                                          Applicants to submit their
                                          responses to the draft grant
                                          terms and conditions of award
                                          and project feedback.
September 30, 2002.....................  Notice of Grant Awards sent to
                                          FY 2002 Systems Change
                                          Grantees.
------------------------------------------------------------------------

[FR Doc. 02-10204 Filed 4-25-02; 8:45 am]
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