[Federal Register Volume 67, Number 92 (Monday, May 13, 2002)]
[Notices]
[Pages 32055-32057]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-11832]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Traumatic Brain Injury Program; Traumatic Brain Injury Protection 
and Advocacy Grants

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds.

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

SUMMARY: The Health Resources and Services Administration (HRSA) 
announces that $1.5 million in fiscal year (FY) 2002 funds is available 
for up to 33 Protection and Advocacy (P&A) Grants to existing State P&A 
systems to provide services to individuals with traumatic brain injury 
(TBI). P&A services include the provision of (1) information, referrals 
and advice; (2) individual and family advocacy; (3) legal 
representation; and (4) specific assistance in self-advocacy. 
Currently, an estimated 5.3 million individuals are living with the 
effects of TBI. TBI can cause chronic physical impairments, and long-
term problems with cognition, emotional functioning, and behavior. A 
recent study by the U.S General Accounting Office (GAO) found that many 
individuals with TBI are not receiving the services they need to remain 
in the community. The purpose of these grants is to improve access and 
coordination of TBI services and supports for individuals and their 
families. All grants will be made under the program authority of the 
Public Health Service Act, Title XII, Section 1253 (42 U.S.C. 300d-53), 
and will be administered by the Maternal and Child Health Bureau 
(MCHB), HRSA. Awards for TBI P&A grants may be approved for up to three 
years. States are eligible for $50,000 each. Territories and American 
Indian Consortia are eligible for $20,000 each. Funding after the 
initial year is contingent upon the availability of funds.

DATES: Applicants are expected to notify MCHB of their intent by May 
24, 2002. The deadline for receipt of applications is June 14, 2002. 
Applications will be considered ``on time'' if they are either received 
on or before the deadline date or postmarked on or before the deadline

[[Page 32056]]

date. The projected award date is August 19, 2002.

ADDRESSES: To receive a complete application kit, applicants may 
telephone the HRSA Grants Application Center at 1-877-477-2123 (1-877-
HRSA-123) beginning May 14, 2002, or register on-line at: http://www.hrsa.gov/_order3.htm directly. The Traumatic Brain Injury P&A Grant 
Program uses the standard Form PHS 5161-1 (rev. 7/00) for applications 
(approved under OMB No. 0920-0428). Applicants must use Catalog of 
Federal Domestic Assistance (CFDA) #93.234D when requesting an 
application kit. The CFDA is a Government-wide compendium of enumerated 
Federal programs, project services, and activities that provide 
assistance. All applications must be mailed or delivered to Grants 
Management Officer, MCHB: HRSA Grants Application Center, 901 Russell 
Avenue, Suite 450 Gaithersburg, MD 20897 telephone 1-877-477-2123: E-
mail: [email protected]. Necessary application forms and an expanded 
version of this Federal Register notice may be downloaded in either 
Microsoft Office 2000 or Adobe Acrobat format (.pdf) from the MCHB Home 
Page at http://www.mchb.hrsa.gov. Please contact Joni Johns, at 301/
443-2088, or [email protected], if you need technical assistance in 
accessing the MCHB Home Page via the Internet. This notice will appear 
in the Federal Register and or HRSA Home page at http://www.hrsa.gov/. 
Federal Register notices are found on the World Wide Web by following 
instructions at: http://www.access.gpo.gov/su_docs/aces/aces140.html.
    Letter of Intent: Notification of intent to apply should be 
directed to Betty Hastings, M.S.W., by email, [email protected]; or 
mail, MCHB, HRSA; Traumatic Brain Injury Program, Parklawn Building, 
Room 18A-38; 5600 Fishers Lane; Rockville, MD 20857.

FOR FURTHER INFORMATION CONTACT: Betty Hastings, M.S.W., 301/443-5599, 
or e-mail: [email protected] (for questions specific to project 
objectives and activities of the program; or the required Letter of 
Intent); Marilyn Stewart, 301/443-1440, email [email protected] (for 
grants policy, budgetary, and business questions).

SUPPLEMENTARY INFORMATION:

Traumatic Brain Injury Program Background and Objectives

    Traumatic brain injury (TBI) is sudden physical damage to the 
brain, often caused by motor vehicle accidents, falls, sports injuries, 
violent crimes, or child abuse. TBI can result in physical, behavioral, 
and/or mental changes, depending on the areas of the brain that are 
injured. TBI is the leading cause of death and disability among young 
people in the United States. Approximately 200,000 Americans die each 
year from traumatic injuries. An additional half million are 
hospitalized. About 10 percent of the surviving individuals have mild 
to moderate problems that threaten their ability to live independently. 
Another 200,000 have serious problems that may require 
institutionalization or some other form of close supervision.
    The number of people surviving TBI has increased significantly in 
recent years because of more effective emergency care; transportation 
to specialized treatment facilities, and acute medical management. 
Currently, an estimated 5.3 million Americans are living with the 
effects of TBI. The direct medical costs for treatment of TBI have been 
estimated to be over $4.5 billion, annually.
    Although TBI can cause chronic physical impairments, often the 
individual has more disability due to problems with cognition, 
emotional functioning, and behavior in connection with interpersonal 
relationships, school, or work. The result is frequently a dramatic 
change in the individual's life-course, profound disruption of the 
family, and huge medical and related expenses over a lifetime. 
Rehabilitation efforts can require years of treatment, starting in the 
hospital, and extending through formal inpatient and outpatient 
rehabilitation to a variety of day treatment or residential programs.
    The cognitive and communication problems of TBI are best treated 
early; often beginning while the individual is still in the hospital. 
Longer-term rehabilitation may be performed individually, in groups, or 
both, depending on the needs of the individual. This therapy often 
occurs in a rehabilitation facility designed specifically for the 
treatment of individuals with TBI. The goal of rehabilitation is to 
help affected individuals progress to the most independent level of 
functioning possible. Therapy focuses on regaining lost skills, as well 
as learning ways to compensate for abilities that have been permanently 
changed because of TBI.
    According to a recent GAO study of services, adults with TBI often 
have permanent disability that requires long-term supportive services 
to remain in the community. In an analysis of eleven States, the gap 
between the number of individuals with TBI receiving long-term services 
and the estimated number of disabled adults with TBI remains wide.
    Until FY 2002, two categories of TBI demonstration grants were 
available: (1) State TBI Planning Grants and (2) State TBI 
Implementation Grants. Thirty-three States and the District of Columbia 
received planning grants to develop an Action Plan to improve the 
State's TBI service system. Grantees developed four ``core capacity'' 
components: (1) A statewide TBI Advisory Board; (2) designated State 
agency and staff position(s) responsible for State TBI activities; (3) 
a statewide needs/resource assessment to address the full spectrum of 
services from initial acute treatment through rehabilitation and long-
term community services for individuals with TBI; and (4) a statewide 
Action Plan outlining steps needed to develop a comprehensive, 
community-based system of care encompassing physical, psychological, 
educational, vocational, and social aspects of TBI services, and 
addressing the needs of individuals with TBI and their families.
    Twenty-six States received Implementation Grants. States used these 
grants to focus on key priorities identified in their statewide action 
plans, including: (1) Leadership in integrating individuals with TBI 
and their families into the broader service delivery system; (2) human 
resources, personnel, training, and education on TBI issues; (3) data 
collection, evaluation, and information management to improve delivery 
of TBI services; (4) public information and education regarding TBI 
issues; (5) and coordination with other public health and disability 
community services.
    The Children's Health Act of 2000, Public Law 106-310, established 
two additional grant categories: (1) Post Demonstration Grants for 
States that have successfully completed a TBI Implementation Grant, and 
(2) TBI Protection and Advocacy (P&A) grants. This notice announces the 
availability of funds specifically for P&A grants. The purpose of P&A 
grants is to provide (1) information, referrals and advice; (2) 
individual and family advocacy; (3) legal representation; and (4) 
specific assistance in self-advocacy to individuals with TBI and their 
families.
    Authorization: Public Health Service Act, Title XII, Section 1253, 
42 U.S.C. 300d-53.
    Purpose: As Congress recognized with the passage of the Traumatic 
Brain Injury Act of 1996 and its reauthorization in the Children's 
Health Act of 2000, there is a pressing need for improved access to and 
coordination of TBI services and support for individuals with TBI and 
their families.

[[Page 32057]]

Additionally, Congress recognized that State (including Tribal and 
Territorial) P&A systems are critical to achieving the goals and 
objectives of the TBI Act. Thus, section 1253 includes language 
authorizing the Secretary, acting through the Administrator of HRSA, to 
make grants to existing State P&A systems for the purposes of 
strengthening P&A service delivery to individuals with TBI and their 
families. The planning and assessment of State TBI P&A systems, 
responsiveness to TBI issues, and outreach strategies to the brain 
injury community are critical to ensure that P&A services will be 
delivered appropriately for individuals with TBI and their families.
    The purpose of these grants, therefore, is to enable State P&A 
systems to develop a plan to address the needs of individuals with TBI 
and their families. These plans are expected to identify the resources 
and operational structure needed to provide P&A services to individuals 
with TBI, identify information needs and develop the ability to provide 
information and advocacy training for individuals with TBI and their 
families, present a mechanism for sustaining TBI P&A activities in 
their States, and provide an operational structure for implementing the 
plan and providing P&A services. Thus, P&A grantees may work with 
individuals with TBI, their families, State TBI grantees, and other 
stakeholders to: (1) Assess statewide needs and capacity; (2) determine 
the best approach for identifying individuals and families within and 
outside the State service system; (3) develop and provide P&A-related 
education and training materials; and, (4) develop an action plan that 
provides a mechanism for serving individuals with TBI and their 
families.
    Eligibility: Eligible for funding are: State P&A systems 
established under part C of the Developmental Disabilities Assistance 
and Bill of Rights Act (42 U.S.C. 6042 et seq.) in the several States 
of the United States, the District of Columbia, the Commonwealth of 
Puerto Rico, the United States Virgin Islands, Guam, American Samoa, 
and the Commonwealth of the Northern Mariana Islands, and American 
Indian Consortia established under part C of the Developmental 
Disabilities Assistance Bill of Rights Act (42 U.S.C. 6042 et seq.).
    Funding Level/Project Period: Projects will be approved for up to 
three years. States are eligible for $50,000 each. Territories and 
American Indian Consortia are eligible for $20,000 each. MCHB expects 
to award 28 P&A grants to States, and 5 P&A grants to U.S. Territories 
and American Indian Consortia. The initial budget period for TBI P&A 
Grants is expected to be 12 months, with any subsequent budget period 
being 12 months. Continuation of any TBI project from one budget period 
to the next is subject to satisfactory performance, program priorities, 
and availability of funds.
    Review Criteria: An objective review panel will evaluate 
applications for P&A grants. Based on the quality of the responses, an 
application may receive up to 100 points on the following review 
criteria:
    1. A plan to enable the P&A system to provide services for 
individuals with TBI and their families (25 points).
     The proposed services.
     The balance of individual TBI cases and systemic work.
     Recognition of the unique needs of the area.
    2. A comprehensive approach to collaboration, partnership and 
outreach (25 points).
     Established relationships with the brain injury community.
     The evidence and breadth of collaboration demonstrated in 
the narrative and letters of support.
     Participation with the State TBI State grant project if 
one exists.
    3. A demonstrated knowledge of the needs of individuals with TBI 
and their families (25 points).
     Financial and human resources have been committed by the 
State P&A towards improving the services for individuals for TBI and 
their families.
     The roles, responsibilities and skills of the project 
staff are sufficient to meet the goals and objectives of the project 
within the proposed time period.
     The project management plan is reasonable and will build 
State P&A capacity.
    4. Project Evaluation (25 points).
     The methodology that will be used to achieve the goals and 
objectives of the project.
     The strength of the project evaluation plan.
    Additional criteria may be used to review and rank applications for 
this competition. Any such criteria will be identified in the program 
guidance included in the application kit. Applicants should pay strict 
attention to addressing these criteria, as they are the basis upon 
which their applications will be judged.

Paperwork Reduction Act

    OMB approval for any data collection in connection with these 
grants will be sought, as required under the Paperwork Reduction Act of 
1995.

Executive Order 12372

    This program has been determined to be a program which is subject 
to the provisions of Executive Order 12372 concerning intergovernmental 
review of Federal programs by appropriate health planning agencies, 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 that have chosen to set up such a review 
system and will provide a single point of contact (SPOC) in the States 
for review. Applicants (other than federally-recognized Indian tribal 
governments) should contact their State SPOCS as early as possible to 
alert them to the prospective applications and receive any necessary 
instructions on the State process. For proposed projects serving more 
than one State, the applicant is advised to contact the SPOC of each 
affected State. The due date for State process recommendations is 60 
days after the application deadline for new and competing awards. The 
granting agency does not guarantee to ``accommodate or explain'' for 
State process recommendations it receives after that date. (See Part 
148, Intergovernmental Review of PHS Programs under Executive Order 
12372 and 45 CFR part 100 for a description of the review process and 
requirements).

    Dated: April 12, 2002.
Elizabeth M. Duke,
Administrator.
[FR Doc. 02-11832 Filed 5-10-02; 8:45 am]
BILLING CODE 4165-15-P