[Federal Register Volume 68, Number 130 (Tuesday, July 8, 2003)]
[Notices]
[Pages 40673-40676]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-17173]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 03044]


Enhancement of an Integrated HIV Program for Voluntary Counseling 
and Testing, Clinical and Home-Based Care in Malawi; Notice of 
Availability of Funds

    Application Deadline: August 7, 2003.

A. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under section 307 of the Public Health 
Service Act, (42 U.S.C. 242l), as amended. The Catalog of Federal 
Domestic Assistance number is 93.941.

B. Purpose

    The Centers for Disease Control and Prevention (CDC) announce the 
availability of fiscal year (FY) 2003 funds for a cooperative agreement 
program for the enhancement of an integrated HIV voluntary counseling 
and testing (VCT), clinical and home-based care program in Malawi.
    The purpose of this program is to provide assistance to a Malawi-
based public or private non-profit organization in the provision of an 
integrated HIV program that includes VCT, clinical care, and home-based 
care in the country of Malawi. This program will also assist in the 
development of plans and strategies for replicating a successful 
service model to extend these service capabilities to other private and 
public sector sites and providers.
    The HIV epidemic in Malawi has matured to the point that both 
illness and mortality are at very high levels. Malawi has recently 
succeeded in garnering initial approval for a large Global Fund award 
to address the HIV epidemic. Three critical elements included in the 
Global Fund award are: (1) VCT; (2) clinical care and treatment for HIV 
and opportunistic infections; and (3) home-based care for HIV-infected 
individuals. Thoughtful, integrated, and innovative programs to address 
this triad of services are urgently needed to effectively address 
implementation of Global Fund activities. Extension of successful 
integrated programs through training and replication of successful 
models is a critical step in increasing availability and accessibility 
to these HIV services for those in need.
    Measurable outcomes of the program will be in alignment with one or 
more of the following performance goals for the National Center for 
HIV, STD and TB Prevention: Working with other countries, USAID, 
international, and U.S. Government agencies, reduce the number of new 
HIV infections among 15 to 24 year olds in sub-Saharan Africa from an 
estimated two million by 2005.

C. Eligible Applicants

    Applications may be submitted by public and private non-profit 
organizations and by governments and their agencies with a current 
capacity for providing three integrated services: (1) VCT; (2) 
ambulatory facility-based HIV clinical care and anti-retroviral (ARV) 
treatment; and (3) home-based care in the country of Malawi. 
Organizations based outside Malawi, including organizations whose 
headquarters are based outside Malawi, are not eligible to apply.

D. Funding

Availability of Funds

    Approximately $175,000 is available in FY 2003 to fund one award. 
It is expected that the award will begin on or about September 15, 2003 
and will be made for a 12-month budget period within a project period 
of up to three years. Funding estimates may change.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.

Use of Funds

    Funds may be utilized only for activities associated with HIV/AIDS. 
CDC funds may be used for direct costs such as salaries; necessary 
travel; operating costs, including supplies, fuel, utilities, etc.; and 
staff training costs, including registration fees and purchase and 
rental of training related equipment.
Antiretroviral Drugs
    The purchase of antiretroviral drugs, reagents, and laboratory 
equipment for antiretroviral treatment projects requires pre-approval 
from the Global AIDS Program headquarters.
Needle Exchange
    No funds appropriated under this Act shall be used to carry out any 
program of distributing sterile needles or

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syringes for the hypodermic use of any illegal drug.
    Funds may be spent for reasonable program purposes, including 
personnel, travel, supplies, and services. Equipment may be purchased 
if deemed necessary to accomplish program objectives, however, prior 
approval by CDC officials must be requested in writing.
    All requests for funds contained in the budget shall be stated in 
U.S. dollars. Once an award is made, CDC will not compensate foreign 
grantees for currency exchange fluctuations through the issuance of 
supplemental awards.
    The costs that are generally allowable in grants to domestic 
organizations are allowable to foreign institutions and international 
organizations, with the following exception: With the exception of the 
American University, Beirut, and the World Health Organization, 
Indirect Costs will not be paid (either directly or through sub-award) 
to organizations located outside the territorial limits of the United 
States or to international organizations regardless of their location.
    The applicant may contract with other organizations under this 
program; however the applicant must perform a substantial portion of 
the activities (including program management and operations, and 
delivery of prevention services for which funds are required).
    You must obtain an annual audit of these CDC funds (program-
specific audit) by a U.S.-based audit firm with international branches 
and current licensure/authority in-country, and in accordance with 
International Accounting Standards or equivalent standard(s) approved 
in writing by CDC.
    A fiscal Recipient Capability Assessment may be required, prior to 
or post award, in order to review the applicant's business management 
and fiscal capabilities regarding the handling of U.S. Federal funds.

Recipient Financial Participation

    Matching funds are not required for this program.

Funding Preferences

    Preference will be given to applicants who can demonstrate, (1) the 
capacity to work with in-patient facilities within an established 
patient referral relationship, and (2) a well-organized program for 
training its own staff, with a capability of extending this training to 
other sites by assisting and mentoring these sites to develop and 
extend the integrated services model.

E. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities listed in 1. 
Recipient Activities, and CDC will be responsible for the activities 
listed in 2. CDC Activities.
1. Recipient Activities
    a. In collaboration with CDC, the applicant will develop plans for 
strengthening existing institutional capacity to enable the expansion 
of the organization's services, and the provision of technical 
assistance including training to extend services nationwide through 
replication of a successful model.
    b. The applicant will provide necessary staff and training time for 
replicating the integrated HIV services model and extending it to 
additional sites.
    c. In collaboration with CDC, develop and conduct training programs 
for staff and other health care providers for extending the integrated 
HIV testing and care model to other sites and providers.
    d. Develop and implement a computerized client record system with 
the goal of maximizing compatibility with established client record 
systems in collaborating facilities, and improve coordination of 
patient care.
    e. Provide safe water system education and support and 
clotrimoxazole prophylaxis to HIV-positive clients in clinical and 
home-based care settings, as indicated, to reduce the occurrence of 
opportunistic infections.
    f. In collaboration with CDC, the applicant will hire or assign 
information management staff with the necessary technical skills and 
experience to implement and manage the computerization of client record 
data.
2. CDC Activities
    a. Collaborate with the grantee on designing and implementing the 
activities listed above, including, but not limited to the provision of 
technical assistance to develop program activities, laboratory 
services, data management and analysis, quality assurance, presentation 
of program results and findings, and management and tracking of 
finances. CDC will accomplish these activities using its own Malawi-
based technical staff or by bringing in consultants from CDC or other 
organizations to accomplish the technical assistance activities.
    b. Assist in training and capacity building to ensure successful 
implementation of program and activities. CDC will assist the recipient 
in enhancing its laboratory services and in conducting quality 
assurance of its HIV testing according to national standards being set 
by the Malawi National Public Health Reference Laboratory.
    c. CDC will assist the recipient organization in conducting 
assessments of the quality of the services provided and maintaining 
high quality services in VCT, clinical care, and home-based care. These 
might include laboratory, monitoring and evaluation, counseling, and 
site management issues including the maintenance of client 
confidentiality.
    d. Assist the recipient in developing and implementing improved 
computerized client record data collection and improved data management 
systems. CDC/GAP/Malawi's information technology specialist and 
epidemiologist will assist in identifying an appropriate staff member 
for the organization and in providing technical assistance to 
computerize and manage clinical and VCT data collected by the 
organization. CDC will assist the organization in using the data to 
inform program improvements.
    e. Assist the successful recipient in hiring a data management 
staff person to work with CDC in developing and implementing the system 
and to manage it long-term.

E. Content

Applications

    The Program Announcement title and number must appear in the 
application. Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. 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 40 pages, double-spaced, 
printed on one side, with one-inch margins, and unreduced 12-point 
font.
    The narrative should consist of, at a minimum, a Plan, Objectives, 
Methods, Evaluation and Budget. The project plan should include 
activities to be conducted throughout the three-year project period.

G. Submission and Deadline

Application Forms

    Submit the signed original and two copies of PHS 5161-1 (OMB Number 
0920-0428). Forms are available at the following Internet address: 
http://www.cdc.gov/od/pgo/forminfo.htm.
    If you do not have access to the Internet, or if you have 
difficulty

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accessing the forms on-line, you may contact the CDC Procurement and 
Grants Office Technical Information Management Section (PGO-TIM) at 
(770)488-2700. Application forms can be mailed to you.

Submission Date, Time and Address

    The application must be received by 4 p.m. Eastern Time August 7, 
2003. Submit the application to: Technical Information Management-PA 
03044, CDC Procurement and Grants Office, 2920 Brandywine Road, 
Atlanta, GA 30341-4146.
    Applications may not be submitted electronically.

CDC Acknowledgement of Application Receipt

    A postcard will be mailed by PGO-TIM, notifying you that CDC has 
received your application.

Deadline

    Applications shall be considered as meeting the deadline if they 
are received before 4 p.m. Eastern Time on the deadline date. Any 
applicant who sends their application by the United States Postal 
Service or commercial delivery services must ensure that the carrier 
will be able to guarantee delivery of the application by the closing 
date and time. If an application is received after closing due to (1) 
carrier error, when the carrier accepted the package with a guarantee 
for delivery by the closing date and time, or (2) significant weather 
delays or natural disasters, CDC will upon receipt of proper 
documentation, consider the application as having been received by the 
deadline.
    Any application that does not meet the above criteria will not be 
eligible for competition, and will be discarded. The applicant will be 
notified of their failure to meet the submission requirements.

H. Evaluation Criteria

    Applicants are required to provide measures of effectiveness that 
will demonstrate the accomplishment of the various identified 
objectives of the cooperative agreement. Measures of effectiveness must 
relate to the performance goals, stated in the purpose section of this 
announcement. Measures must be objective and quantitative and must 
measure the intended outcome. These measures of effectiveness must be 
submitted with the application and will be an element of evaluation.
    An independent review group appointed by CDC will evaluate each 
application against the following criteria:
    1. Ability to Carry Out the Project (40 points). The extent to 
which the applicant understands and describes activities which are 
realistic, achievable, time-framed and appropriate to effectively plan, 
coordinate, and complete these activities. Applicant must show how and 
at what intervals the effectiveness and productivity of this program 
activity will be monitored and evaluated. Applicant should include a 
description of applicant organizational structure and use it to explain 
how the work will be carried out.
    2. Technical and Programmatic Approach (20 points). The extent to 
which the applicant's proposal demonstrates understanding of the 
technical and organizational aspects of conducting all included HIV 
testing and care activities and computerization of client record data.
    3. Personnel (20 points). The adequacy of personnel, including 
training, availability, and experience, in order to carry out the 
technical and organizational aspects of all proposed activities.
    4. Administrative and Accounting Management Plan (20 points). (a) 
The adequacy of the plans to account for, prepare reports, monitor, and 
audit expenditures under this agreement; (b) The extent to which the 
application demonstrates ability to administer and manage the budget; 
(c) The extent to which the budget is itemized and well justified; (d) 
Demonstration of plans to engage an outside accounting firm to design 
and manage the financial system to meet CDC and the recipient's 
accounting requirements.
    5. Budget (Not rated, but evaluated). The extent to which the 
budget is detailed, clear, justified, provides direct support, and is 
consistent with the proposed program activities.
    6. Protection of Human Subjects (Not rated, but evaluated). Does 
the application adequately address the requirements of Title 45 CFR 
part 46 for the protection of human subjects? (Not scored; however, an 
application can be disapproved if the research risks are sufficiently 
serious and protection against risks is so inadequate as to make the 
entire application unacceptable.)

I. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. Interim progress report, no less than 90 days before the end of 
the budget period. The progress report will serve as your non-competing 
continuation application, and must contain the following elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Detailed Line-Item Budget and Justification.
    e. Additional Requested Information.
    2. Financial status report, no more than 90 days after the end of 
the budget period.
    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.

Additional Requirements:

    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment I of the 
program announcement, as posted on the CDC Web site.

AR-4 HIV/AIDS Confidentiality Provisions.
AR-6 Patient Care.
AR-8 Public Health System Reporting Requirements.
AR-9 Paperwork Reduction Act Requirements.
AR-12 Lobbying Restrictions.
AR-14 Accounting System Requirements.

    Executive Order 12372 does not apply to this program.

J. Where To Obtain Additional Information

    This and other CDC announcements, the necessary applications, and 
associated forms can be found on the CDC Web site, Internet address: 
http://www.cdc.gov Click on ``Funding'' then ``Grants and Cooperative 
Agreements.''
    For general questions about this announcement, contact: Technical 
Information Management, CDC Procurement and Grants Office, 2920 
Brandywine Road, Atlanta, GA 30341-4146, Telephone: 770-488-2700.
    For business management and budget assistance, contact: Cynthia 
Montgomery, Grants Management Specialist, Procurement and Grants 
Office, Centers for Disease Control and Prevention, 2920 Brandywine 
Road, Atlanta, GA 30341-4146, Telephone: 770-488-2757
    For program technical assistance, contact: Margarett Davis, MD, 
MPH, Kang'ombe Building 8 West, Lilongwe, Malawi, Telephone Number: 
265-1-775-188, Fax Number: 265-1-775-848, E-mail address: 
[email protected]. Mailing Address: c/o U.S. Embassy, PO Box 30016, 
Lilongwe 3, Malawi.


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    Dated: July 1, 2003.
Edward Schultz,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 03-17173 Filed 7-7-03; 8:45 am]
BILLING CODE 4163-18-P