[Federal Register Volume 68, Number 140 (Tuesday, July 22, 2003)]
[Notices]
[Pages 43361-43363]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-18632]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

[HRSA-03-039]


Fiscal Year 2003 Competitive Application Cycle for the Healthy 
Communities Access Program (HCAP); CFDA Number 93.252

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice of availability of funds for new awards.

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    Legislative Authority: The ``Health Care Safety Net Amendments of 
2002'' (Pub. L. 107-251) amended Part D of Title III of the Public 
Health Service (PHS) Act by inserting a new Subpart V, Section 340, 
creating the Healthy Communities Access Program (HCAP). Section 340 of 
the PHS Act (42 U.S.C. 256) authorizes the award of competitive grants 
to eligible entities to assist in the development of integrated health 
care delivery systems to serve communities of individuals who are 
uninsured and/or underinsured.
    Purpose: To provide assistance to communities and consortia of 
health care providers and others they represent to develop or continue 
activities to strengthen integrated community health care delivery 
systems that coordinate health care services for individuals who are 
uninsured or underinsured, and to develop or strengthen activities 
related to providing coordinated care for individuals with chronic 
conditions who are uninsured or underinsured.
    Eligibility: Tribal, faith-based and community-based organizations 
are encouraged to apply. For an entity to be eligible to receive a new 
HCAP award, the following requirements must be met:
    1. The applicant entity must represent a consortium whose principal 
purpose

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is to provide a broad range of coordinated health care services to 
their defined community's uninsured and underinsured populations.
    2. The community-wide consortium represented by the applicant 
entity must include at least one of each of the following providers 
that serve the stated community, unless such provider does not exist, 
declines or refuses to participate, or places unreasonable conditions 
on its participation:
    [sbull] A Federally qualified health center (as defined in section 
1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa));
    [sbull] A hospital with a low-income utilization rate (as defined 
in section 1923(b)(3) of the Social Security Act (42 U.S.C. 1396r-
4(b)(3)), that is greater than 25 percent;
    [sbull] A public health department; and
    [sbull] An interested public or private sector health care provider 
or an organization that has traditionally served the medically 
uninsured and underserved.
    3. The applicant entity is neither a current nor former Community 
Access Program (CAP) grantee and is proposing to serve either a service 
area or target population of uninsured and underinsured individuals 
that has not been exclusively served by a previous CAP grant.
    For an existing CAP grantee to be eligible to receive a completing 
Continuation HCAP award, the following requirements must be met.
    1. The applicant entity must represent a consortium whose principal 
purpose is to provide a broad range of coordinated health care services 
to their defined community's uninsured and underinsured populations.
    2. The community-wide consortium represented by the applicant 
entity must include at least one of each of the following providers 
that serve the stated community, unless such provider does not exist, 
declines or refuses to participate, or places unreasonable conditions 
on its participation:
    [sbull] A Federally qualified health center (as defined in section 
1861(aa) of the Social Security Act (42 U.S.C. 1395x(aa));
    [sbull] A hospital with a low-income utilization rate (as defined 
in section 1923(b)(3) of the Social Security Act (42 U.S.C. 1396r-
4(b)(3)), that is greater than 25 percent;
    [sbull] A public health department; and
    [sbull] An interested public or private sector health care provider 
or an organization that has traditionally served the medically 
uninsured and underserved.
    Existing CAP grantees seeking a 4th year if funding must 
demonstrate extraordinary circumstances, i.e., an event (or events) 
outside the control of the eligible entity that has prevented the 
eligible entity from fulfilling the objectives described by such entity 
in their approved grant application for the budget period for the 
preceding fiscal year. The event(s) and impact, or impact alone, of any 
of the extraordinary circumstances noted below must have occurred 
during the applicant's budget period (September 1, 2002--August 31, 
2003) for the preceding fiscal year. Examples include: Natural 
disasters or other major disruptions to the security or health of the 
community served by the applicant that directly and adversely affect 
the applicant; or significant economic deteriorations in the community 
served by the applicant that directly and adversely affect the 
applicant.

DATES: The timelines for application submission and award are as 
follows:
    Application Deadline: August 26, 2003.
    Grant Awards Announced: September 28, 2003.
    Applications will be considered on time if they are received by 5 
p.m. eastern standard time on August 26, 2003 or before the established 
deadline. Applicants should obtain a legibly dated receipt from a 
commercial carrier or the U.S. Postal Service or request a legibly 
dated U.S. Postal Service postmark. Private metered postmarks will not 
be accepted as proof of timely mailing. Applicants sent to any address 
other than that specified below are subject to being returned. 
Applicants will receive notification of their application receipt. 
Applicants should note that HRSA will be accepting grant applications 
online in the last quarter of the fiscal year (July through September). 
Please refer to the HRSA grants schedule at http://www.hrsa.gov/grants.htm for more information.
    How To Request and Submit an Application: To obtain a complete 
application kit (i.e., application instructions, necessary forms, and 
application review criteria), call toll free 1-877-HRSA-123 (1-877-477-
2123). When contacting the HRSA Grants Application Center (GAC) please 
refer to the program announcement number HRSA-03-39 and the name of 
this program.
    An original and two copies of the application must be sent to: HRSA 
Grants Application Center, 901 Russell Avenue, Suite 450, Gaithersburg, 
Maryland 20879; FAX: 1-877-HRSA-345 (1-877-477-2345); E-mail: 
[email protected].
    Application Review and Funding Criteria: Each application received 
by the deadline will be screened for eligibility. An application will 
be considered eligible if it meets all of the specific eligibility 
requirements listed above. Applications that do not meet the 
eligibility requirements will not be accepted for processing and will 
be returned. An Objective Review Committee (ORC) will review all 
eligible applications. The review criteria used by the Objective Review 
Committee to assess each application (out of 100 points) will include:
    [sbull] Community Health Care Delivery System Needs Assessment 
(maximum 10 points): Extent to which the applicant clearly defines the 
service area and target population of uninsured and underinsured 
individuals for the project and provides a detailed assessment of the 
current delivery system for the applicant's uninsured and underinsured 
populations so as to describe the extent of unmet need for a more 
coordinated system of care.
    [sbull] Consortium Organizational and Functional Structure (Maximum 
15 Points): Extent to which the applicant describes the history, 
membership, functional structure, accountability, and strategies of the 
applicant's HCAP consortium in terms of its capacity to implement an 
efficient, higher quality, comprehensive system of care for the stated 
target population of uninsured and underinsured individuals.
    [sbull] Project Work Plan (Maximum 35 Points): Extent to which the 
applicant's work plan demonstrates the clarity, feasibility, and scope 
of proposed activities, goals, and measurable objectives which are 
consistent and aligned with stated needs and will develop or strengthen 
an integrated community health care delivery system that provides more 
efficient, effective, coordinated, and quality care at a lower cost for 
the stated population of uninsured or underinsured individuals.
    [sbull] Program Performance Plan (Maximum 15 Points): Extent to 
which the applicant provides an appropriate plan for evaluation of the 
activities carried out under the grant that ensures monitoring and 
measurement of progress towards the corresponding goals and objectives 
as well as the use of evaluation findings to improve program 
performance and support sustainability.
    [sbull] Sustainability Plan (Maximum 15 Points): Extent to which 
the applicant provides an appropriate plan for long-term project 
sustainability and community-reinvestment for HCAP

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activities through decreasing dependence on Federal funds.
    [sbull] Budget (Maximum 10 Points): Extent to which the applicant 
presents a detailed, clear and comprehensive budget that is appropriate 
and reasonable for the scope of proposed activities described in the 
Project Work Plan and which adequately documents and demonstrate the 
use of non-Federal contributions to the greatest extent possible for 
the proposed HCAP project.
    Further evaluation/review criteria detail will be listed in the 
application guidance.
    Funding Preference: A funding preference is defined as the funding 
of a specific category or group of approved applications ahead of other 
categories or groups of approved applications. There is one preference 
under this funding opportunity. A preference will be accorded to 
applicants that demonstrate the greatest extent of unmet need in the 
community involved for a more coordinated system of care.
    Matching or Cost Sharing Requirement: No match or cost sharing 
required.
    Estimated Amount of Available Funds: $35,000,000 for New Awards and 
$70,000,000 for Competing Continuations.
    Estimated Number of Awards: Up to 35 New Awards and 100 Competing 
Continuations.
    Estimated Average Size of Each Award: New awards will range from 
$800,000 to $900,000 and Competing Continuations will range from 
$600,000 to $700,000.
    Estimated Project Period: Up to three years for new award. For 
competing continuations, Cap Grantees that received: (1) Their initial 
funding in fiscal year 2000 are eligible for a one year project period 
under Extraordinary Circumstances; (2) their initial funding in fiscal 
year 2001 are eligible for a one year project period under this 
announcement; and (3) their initial funding in fiscal year 2002 are 
eligible for up to a two year project period under this announcement.

FOR FURTHER INFORMATION CONTACT: Tracy McClintock, phone number: (301) 
594-4300, e-mail:[email protected].
    Paperwork Reduction Act: The application for the Healthy 
Communities Access Program has been approved by the Office of 
Management and Budget (OMB) under the Paperwork Reduction Act. The OMB 
clearance number is 0920-0428.
    Public Health System Reporting Requirements: Under these 
requirements (approved by the Office of Management and Budget under OMB 
number 0937-0195), a community-based non-governmental applicant must 
prepare and submit a Public Health System Impact Statement to the head 
of the appropriate State and local health agencies in the area(s) to be 
impacted no later than the Federal application receipt due date. This 
statement must include:
    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 and local health agencies.
    Executive Order 12372: This program has been determined to be 
subject to provisions of Executive Order 12372, 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 Form PHS 5161 contains a 
listing of States that have set up a review system and will provide a 
State Point of Contact (SPOC) in the State for the review. A list of 
SPOC contacts is also available at http://www.whitehouse.gov/omb/grants/spoc.html. Applicants (other than federally-recognized Indian 
tribal governments) 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.
    Except in unusual circumstances, the due date for State process 
recommendations is at least 60 days from the deadline date established 
by the Secretary. 45 CFR 100.8(a)(2). In this instance, there are less 
than 90 days before the end of the 2003 fiscal year (on September 30, 
2003). Due to this unusual circumstance, HRSA is establishing a 30-day 
due date for State process recommendations to assure timely 
consideration of such recommendations. The 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 45 CFR Part 
100, for a description of the review process and requirements).

    Dated: July 15, 2003.
Elizabeth M. Duke,
Administrator.
[FR Doc. 03-18632 Filed 7-21-03; 8:45 am]
BILLING CODE 4165-15-P