[Federal Register Volume 69, Number 36 (Tuesday, February 24, 2004)]
[Notices]
[Pages 8460-8471]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-3867]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service

[CFDA Number: 93.933]


Native American Research Centers for Health; New Request for 
Application of Funds

    Key Dates: Letter of Intent Deadline: May 1, 2004; Application 
Deadline: June 18, 2004.

Overview

    The Indian Health Service (IHS), with the National Institute of 
General Medical Sciences (NIGMS) of the National Institutes of Health, 
and the Agency for Healthcare Research and Quality (AHRQ) announces an 
initiative to support the Native American Research Centers for Health 
(NARCH) grant. This funding mechanism will develop opportunities for 
conducting research and research training to meet the needs of American 
Indian/Alaska Native (AI/AN) communities. Competing grant applications 
for Fiscal Year (FY) 2005 will be accepted with a receipt date of June 
18, 2004. There will be only one funding cycle for FY 2005. Awards will 
be subject to the availability of funds and grants will be administered 
in accordance with applicable Office of Management and Budget (OMB) 
Circulars, Department of Health and Human Services grant regulations at 
45 CFR parts 74 and 92, the Public Health Service Grants Policy 
Statement, and other applicable Departmental, IHS, AHRQ and NIH 
policies and procedures such as the regulations governing protection of 
human subjects at 45 CFR part 46.
    This initiative is described in the Catalog of Federal Domestic 
Assistance

[[Page 8461]]

Nos. 93.933 and 93-375. Sections 301(a) and 405 of the Public Health 
Service Act, as amended authorize these awards, and these are 
administered under PHS grants policies and Federal Regulations 42 CFR 
part 52c, 45 CFR part 74, and 45 CFR part 92. See also Senate 
Appropriations Committee Report, No. 92-316, July 29, 1971, Executive 
Order 12900, Educational Excellence for Hispanic Americans February 22, 
1994, Executive Order 12876, Historically Black Colleges and 
Universities, November 1, 1993, and Executive Order 13021, October 21, 
1996, and Outline of Work Plan, August 18, 1998, White House Initiative 
on Tribal Colleges and Universities. Applications are not subject to 
the intergovernmental review requirements of Executive Order 12372 or 
Health Systems Agency review.
    The PHS strongly encourages all grant and contract recipients to 
provide a smoke-free workplace and 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. This is consistent with the PHS mission to 
protect and advance the physical and mental health of the American 
people.

I. Funding Opportunity Description

    The NARCH initiative will support partnerships between AI/AN Tribes 
or Tribally-based organizations such as the National Indian Health 
Board and Area Health Boards, and institutions that conduct intensive 
academic-level biomedical, behavioral and health services research. 
These partnerships are called Native American Research Centers for 
Health (NARCH). The purposes of the NARCH initiative are:
    1. To develop a cadre of AI/AN scientists and health professionals 
engaged in biomedical, clinical, behavioral and health services 
research who will be competitive in securing NIH and AHRQ funding;
    2. To increase the capacity of both research-intensive institutions 
and AI/AN organizations to work in partnership to reduce distrust by 
AI/AN communities and people toward research; and
    3. To encourage competitive research linked to the health 
priorities of the AI/AN organizations and to reducing health 
disparities.
    These purposes will be achieved by supporting student development 
projects, faculty/researchers development projects, and research 
projects (including pilot projects) developed by each NARCH 
partnership.

II. Award Information

    The estimated funds (total costs) available for the first year of 
support for the entire initiative is expected to be over $ 2.2 million 
in Fiscal Year 2005. The actual amount may vary, depending on the 
response to the RFA and availability of funds.
    An application may request a project period not to exceed four 
years of support, and direct costs not to exceed $800,000 in the first 
year. Direct costs to the applicant include the entire cost of each 
subcontract--that is, each subcontract's direct cost plus the 
subcontract's appropriate Facilities and Administration (F&A) cost. 
Because it is anticipated that all budget requests will exceed 
$250,000, the modular grant requirements would not apply to this RFA. A 
minimum of 30 percent of the grant funds must remain with the applicant 
organization.
    Awards under this initiative will be administered using the 
competing institutional grant mechanism of the IHS, and will be 
reviewed using the NIH S06 mechanism. The responsibility for planning, 
directing, and executing the program, as well as data acquisition and 
analysis and evaluation of the proposed program, lies solely with the 
applicant organization. The maximum grant period may not exceed four 
years, with the opportunity for a competing renewal at the end of that 
period.

III. Eligibility Information

    The proposed NARCH must be a working partnership of the AI/AN 
organization and of the research-intensive institution. Applicants 
eligible to receive a NARCH award are the AI/AN organizations of the 
partnerships. As the grantee, the AI/AN organizations will define 
criteria and eligibility for participation in all aspects of the 
partnership, consistent with this announcement. A minimum of 30 percent 
of the grant funds must remain with that AI/AN organization, that is, 
no more than 70 percent may be subcontracted to other institutions or 
organizations.

1. Eligible Applicants

    The AI/AN applicant must be one of the following:
    A. A federally recognized Indian Tribe; or
    B. A Tribally sanctioned non-profit Tribal organization; or
    C. A non-profit national or area Indian health board; or
    D. A consortium of two or more of those Tribes, Tribal 
organizations, or health boards.
    Applicants are strongly encouraged to establish eligibility of 
their proposed applications prior to submission. Inquiries about 
eligibility should be addressed to Phillip L. Smith, M.D., M.P.H., at 
(301) 443-0222.

2. Cost Sharing or Matching

    The proposed NARCH must have:
    A. A Community and Scientific Advisory Council with more than 50 
percent of its membership being appointed by the AI/AN applicant.
    B. The proposed NARCH may include additional affiliated 
organizations, e.g., Tribal colleges, additional colleges or 
universities, additional Tribes, or other Indian communities or 
organizations.
    NARCH applicants are encouraged to have an affiliation with an 
applicable component of the IHS for technical and other in-kind 
support, such as linking data from IHS and others to understand better 
the health status of the involved Tribes or communities.

3. Other (Required)

    A. The Research-Intensive Partner must: be an accredited public or 
private nonprofit university or other institution that has an 
established record of conducting research into the health problems of 
AI/AN; have demonstrated a commitment to enhancing the capability of 
AI/AN faculty/researchers, students, investigators, and communities to 
engage in biomedical, behavioral, clinical and health services 
research; and have demonstrated a commitment to mentoring AI/AN 
faculty/researchers, students, and investigators.
    B. Principal Investigator: The Principal Investigator, the 
individual responsible for the administration (including fiscal 
management) of the overall project, must have his/her primary 
appointment with the AI/AN applicant organization. Special arrangements 
of employment, such as inter-organizational personnel agreements, are 
permissible. The Principal Investigator may be, but is not required to 
be, the NARCH Program Director or a Research Project Investigator.
    C. NARCH Program Director: The NARCH Program Director is the 
individual responsible for the day-to-day leadership and management of 
the research and training programs within the proposed NARCH. The 
Program Director may be, but is not required to be, the Student and 
Faculty/Researcher Development Director or a Research Project 
Investigator.

[[Page 8462]]

    D. Student and Faculty/Researcher Development Director and 
Participants: The NARCH initiative is an institutional developmental 
grant mechanism that places an emphasis on the continual development of 
students and faculty/researchers. In order to be included as the 
Student and Faculty Development Director, the prospective director must 
have a faculty/researcher appointment at the research-intensive 
institution or equivalent appointment at the AI/AN organization or 
other consortium partner, and must demonstrate that he/she has the 
knowledge, skills, and capabilities to mentor students and faculty/
researchers and to generate and direct development and mentoring 
programs. The Student and Faculty Development Director may be the NARCH 
Program Director. Faculty/researchers and students should be supported 
in research education activities that improve their skills and 
abilities to be successful at the next stage of their professional 
development. To be included as a participant for faculty/researcher 
development in the proposed NARCH, the individual must have a faculty/
researcher appointment at the research-intensive institution or 
equivalent appointment at the AI/AN organization or other consortium 
partner.
    E. Research Project Investigators: The NARCH initiative is an 
institutional developmental grant mechanism that places an emphasis on 
continual improvement of the research competitiveness of the research 
investigators. In order to be included as a research project 
investigator in the proposed NARCH, a prospective investigator must 
have a faculty appointment at the research-intensive institution or 
equivalent appointment at the AI/AN organization or other consortium 
partner, and must show that he/she has the need, based on 
institutional, departmental, and professional development plans, to 
enhance his/her research knowledge, skills, and capabilities by 
engaging in the proposed research program and associated activities.
    F. Tribal Approval of the Application: It is the policy of the IHS 
that all research involving AI/AN Tribes be approved by the Tribal 
governments with jurisdiction. Therefore, the following documentation 
is required as part of the application:

 For a federally recognized Indian Tribe--a 
resolution of support from the Tribal government must be part of the 
application. Applications that involve more than one Indian Tribe must 
include resolutions of support from all participating Tribes.
 For an eligible consortium of Tribes--a resolution 
of support from each Tribe of the consortium must be included.
 For a Tribally sanctioned non-profit Tribal 
organization--specific Tribal resolution(s) of support will not be 
required if the current Tribal resolution(s) under which the 
organization operates encompasses the proposed application. (A copy of 
the current operational resolution(s) must be submitted with the 
application.) An official signed resolution must be received by the 
Grants Management Branch, IHS, no later than June 18, 2004 at the Reyes 
Building, 801 Thompson Avenue, Rockville, MD 20852-1627. A grant will 
not be awarded unless the signed resolution is received by this date.
 For a non-profit national or area Indian health 
board, or a consortium of those eligible Indian health boards--a 
resolution is not required. However, the applicant organization must 
submit a letter of support signed by the executive director of each 
health board involved, specifically citing the research project 
proposed. Each AI/AN organization that derives benefit from the grant 
must also submit such a letter.

    G. Mechanism of Support: Awards under this initiative will be 
administered using the competing institutional grant mechanism of the 
IHS, and will be reviewed using the NIH S06 mechanism. The 
responsibility for planning, directing, and executing the program, as 
well as data acquisition and analysis and evaluation of the proposed 
program, lies solely with the applicant organization. The maximum grant 
period may not exceed four years, with the opportunity for a competing 
renewal at the end of that period.

IV. Application and Submission Information

1. Address To Request Application Package

    NARCH Program Director,
    801 Reyes Building, TMP Suite 450,
    Rockville, MD 20852.

2. Content and Form of Application Submission

    A. The purposes of the NARCH initiative must include:

     To develop a cadre of AI/AN scientists and 
health professionals engaged in biomedical, clinical, behavioral and 
health services research that is competitive to NIH funding;
     To increase the capacity of both research-
intensive institutions and AI/AN organizations to work in partnership 
to reduce distrust by AI/AN communities and people toward research; and
     To encourage competitive research linked to the 
health priorities of the AI/AN partner and to reducing health 
disparities.

    B. A proposed NARCH, therefore, may include any or all of the 
following components: student development projects; faculty/researcher 
development projects; research projects (including pilot projects); and 
``core'' administrative facility.
    C. The content of the application should explain the components of 
the application, and how they help meet the purposes of the NARCH 
initiative.

 A description should be provided of the current 
state of the research and research training enterprise at the proposed 
NARCH and its institutional and community partners, including faculty/
researcher and student profiles.
 A clear statement should be presented of the overall 
goals, specific measurable objectives, and anticipated milestones. 
These elements should be presented in the context of needed 
improvements in the partners' organizational infrastructure and 
environment for research.
 Documentation should be provided to establish that 
the research-intensive partner is an institution with a record of 
conducting research into the health of AI/ANs, and that it has a 
demonstrated commitment to the special encouragement of, and assistance 
to, AI/AN faculty/researchers, students, investigators, and communities 
for enhancing their capacity to engage in biomedical, behavioral and 
health services research.
 Documentation about the nature of the partnership 
itself should be included, such as: the process to develop the 
application and proposed NARCH itself, the past and future efforts to 
increase the capacity of the partners to improve their partnership, and 
to contribute to the success of the NARCH.
 A plan for assessment of the benefits of the 
activities by the proposed NARCH on specific, measurable outcomes 
identified in the application should be provided. IHS and NIGMS 
recognize that Tribes, Tribally-based organizations, and research-
intensive institutions are diverse in their missions, their health and 
economic

[[Page 8463]]

statuses, and their cultures. Such an assessment could include a self-
study by the proposed NARCH and its partners, which focuses on fact-
finding, program evaluation, and recommendations for improvement in key 
areas.
 Strategies for determining the initial and ongoing 
success of their efforts for organizational development should also be 
presented. It is expected that each proposed NARCH will develop its own 
set of strategies that best match its circumstances.
    Guidance and suggestions for program evaluation of a proposed NARCH 
can be obtained from http://www.the-aps.org/education/promote/promote.html.
    Applicants are strongly urged to contact NARCH initiative staff at 
an early stage to request the specific supplementary instructions for 
the PHS 398 for the NARCH grants. Application kits and supplementary 
instructions may be obtained from the initiative contacts listed under 
VII. Agency Contacts.

     The PHS 398 (updated 9/09/03) research grant 
application instructions and forms at http://grants.nih.gov/grants/funding/phs398/phs398.html are to be used in applying for these grants. 
This version of the PHS 398 is available in an interactive, searchable, 
PDF format. The NIH will return applications that are not submitted in 
the 09/09/03 updated format. For further assistance contact Grants 
Info, telephone (301) 435-0714, e-mail: [email protected].
 ``DUNS'' number

    Applications must be prepared using the PHS 398 research grant 
application instructions and forms (updated 09/09/03). As of October 1, 
2003, applications must have a Dun and Bradstreet (D&B) Data Universal 
Numbering System (DUNS) number as the Universal Identifier when 
applying for Federal grants or cooperative agreements. The DUNS number 
can be obtained by calling (866) 705-5711 or through the Web site at 
http://www.dunandbradstreet.com/. The DUNS number should be entered on 
line 11 of the face page of the PHS 398 form. The PHS 398 document is 
available at http://grants.nih.gov/grants/funding/phs398/phs398.html in 
an interactive format. For further assistance contact Grants Info, 
Telephone (301) 435-0714, e-mail: [email protected].
    Internet applications for a DUNS number can take up to 30 days and 
this could cause organizations to lose opportunities to apply, or delay 
them until the next round. It is significantly faster to obtain one by 
phone.
    You will need the following information to request a DUNS number:

 Organization name
 Organization address
 Organization telephone number
 Name of CEO, Executive Director, President, etc. 
(The person in charge)
 Legal structure of the organization
 Year organization started
 Primary business (activity) line
 Total number of employees.

    D. The RFA label available at http://grants1.nih.gov/grants/funding/phs398/label-bk.pdf in the PDF format, must be affixed to the 
bottom-face page of the application. Type this RFA number: ``NOT GM-04-
107'' on the label. Failure to use this label could delay processing 
the application and it may not reach the review committee in time for 
review. In addition, the ``Native American Research Centers for 
Health'' and the RFA number must be typed on line 2 of the face page of 
the application form and the YES box must be marked.
    E. Student Development Projects: If student development projects 
are proposed, the NARCH application should describe new programs, 
modifications, or additions, to existing programs of the partners that 
encourage and facilitate AI/AN students to enter, advance, and remain 
in research careers. Such projects might include, but are not limited 
to, providing employment as research assistants in research projects of 
research-active mentors with an explicit mentoring plan, providing 
other mentoring with an explicit mentoring plan, providing workshops to 
improve technical or communication skills, providing motivating 
seminars or journal clubs highlighting problems of interest to 
students, providing contact with role models, and providing 
opportunities to travel to present results at national scientific 
meetings.
    If research mentorships or apprenticeships are proposed, the 
application should clearly document the experience, proposed 
commitment, and quality of the mentors in providing guidance and advice 
to students (including responsible conduct of research and research 
integrity, teaching, and protection of human subjects), and in 
fostering the development of academic and/or community-based AI/AN 
researchers.
    The application should describe how the development plans for the 
student will meet both the individual's professional development goals, 
and one purpose of the NARCH initiative: to develop a cadre of AI/AN 
scientists and health professionals.
    The application must have an evaluation plan for the project(s) 
that indicates the anticipated outcomes relative to the current 
baseline data. For example, one outcome might be the improved retention 
of students in science majors. The application should indicate the 
anticipated (quantitative) improvement relative to the current 
retention rate.
    A student in a NARCH Student Development Project must be a full-
time or part-time student officially enrolled in an educational program 
leading to an undergraduate or graduate degree, or in a post-doctoral 
educational program, or (if well justified) in late high school. A 
helpful book about mentoring science students is found at http://books.nap.edu/catalog/5789.html.
    F. Faculty/Researcher Development Projects: If faculty/researcher 
development projects are proposed, the NARCH application should 
describe the need, proposed activity, and anticipated outcomes. 
Faculty/researcher development projects might include, but are not 
limited to, short-term mentored research experiences in the lab of an 
active NIH-extramurally-funded researcher with an explicit mentoring 
plan, long-term general mentoring under an explicit mentoring plan, or 
attendance at workshops or courses or national meetings needed for 
acquiring specific skills or methodologies needed for prospective 
research.
    As with student development projects, the application should 
document the experience, proposed commitment, and quality of the 
mentors, teachers, or experience in providing guidance and advice to 
faculty/researcher, and in fostering the development of academic and 
community-based AI/AN research.
    The application must also describe the evaluation plan for the 
faculty/researcher development project.
    The application must clearly describe how the development plans for 
faculty/researcher will meet both the individual's professional 
development goals, and two purposes of the NARCH initiative: to develop 
a cadre of AI/AN scientists and health professionals, and to enhance 
the partnership of the proposed NARCH.
    G. Research Projects: NARCH applications may include a maximum of 
five (5) regular research projects and a maximum of five (5) pilot 
research projects. Unlike regular research projects, a pilot research 
project is limited in scope and is not expected to have preliminary 
data. It is also limited to a budget of no more than $50,000 direct 
costs per year for four years. The pilot research project is intended 
for

[[Page 8464]]

faculty/researchers without current research support. Support for 
faculty/researchers participating in pilot research projects is 
preparatory to seeking more substantial funding from NIH research grant 
programs (e.g., Academic Research Enhancement Award [AREA], K, and R01 
awards), as well as funding from other agencies and private sources. 
Funds received from the proposed NARCH to support pilot research 
projects may not be used to supplement ongoing research projects. A 
NARCH application need not include both research projects and pilot 
research projects. Applications for only pilot research projects or for 
only research projects may be submitted. Individual project 
investigators may propose either a research project or a pilot research 
project, but not both.
    Research projects (including pilot research projects) proposed 
under this initiative must be in research areas normally funded by any 
of the National Institutes of Health or the Agency for Healthcare 
Research and Quality (AHRQ). Research projects addressing health 
disparities and the health priorities of the AI/AN partner are 
especially encouraged.
    A listing of grants recently funded by NIH may be found at CRISP 
(Computer Retrieval of Information on Scientific Projects), a 
searchable database of federally funded biomedical research projects 
conducted at universities, hospitals, and other research institutions. 
It may be accessed at (http:/crisp.cit.nih.gov/). Grants funded by AHRQ 
can also be found on CRISP as well as on GOLD (Grants On-Line Database) 
which can be found at (http://www.gold.ahrq.gov/).
    Each research project or pilot research project should follow the 
instructions provided in PHS 398 (updated 09/09/03) for preparing 
research grant applications. The professional development goals must 
clearly describe specific objectives and milestones which should 
include, but are not limited to, improving competitiveness in acquiring 
grant support. The applicant should describe how successful completion 
of the proposed research project will improve the research skills, and 
will help develop the students and faculty/researcher, thus 
contributing to the overall goals and specific measurable objectives of 
the proposed NARCH.
    Each research project or pilot research project must follow the IHS 
policy concerning Tribal approval, that all research involving AI/AN 
Tribes be approved by the Tribal governments with jurisdiction. That 
is, each grantee must include a resolution of approval from the Tribal 
government[s], or (if applicable) a letter of support signed by the 
director of the eligible AI/AN organization, or both (if applicable) 
for projects that involve people or community[ies] of an AI/AN Tribe, 
or an eligible non-profit organization.

3. Submission Dates and Times

    A. Letter of Intent Deadline: May 1, 2004.
    Prospective applicants are asked to submit a letter of intent that 
includes the title of the proposed NARCH, the name, address, and 
telephone number of the Principal Investigator and its Program 
Director, the identities of the partners and of key personnel, and the 
number and title of this RFA. The letter of intent must be received by 
Dr. Michael R. Martin at the Center for Scientific Review, MSC 7892, 
Room 6160, 6701 Rockledge Drive, Bethesda, MD 20892-7892, telephone: 
(301) 594-7945, Fax: (301) 480-2065, e-mail: [email protected], before 6 
p.m. EST on May 1, 2004. Letters may be submitted by mail, fax or e-
mail.
    Although a letter of intent is not required, is not binding, and 
does not enter into the review of a subsequent application, the 
information that it contains allows the IHS and NIH Center for 
Scientific Review (CSR) staffs to estimate the potential review 
workload and avoid conflict of interest in the review.
    B. Application and Resolution Deadline: June 18, 2004.
    The applications must be received before 6 p.m. EST on June 18, 
2004. If an application is received after that date, it will be 
returned to the applicant without review. To be considered timely, an 
application must be sent on or before the deadline date. If sent timely 
(with documented proof of mailing) but received after the deadline, an 
application will be accepted for review only if it is received in time 
for orderly processing. Competing applications not meeting the deadline 
date specified in the announcement are considered late applications and 
will not be considered for funding under that announcement.
    The Center for Scientific Review (CSR) will not accept any 
application in response to this RFA that is essentially the same as one 
currently pending initial review, unless the applicant withdraws the 
pending application. The CSR will not accept any application that is 
essentially the same as one already reviewed. This does not preclude 
the submission of substantial revisions of applications already 
reviewed, but such applications must include an introduction addressing 
the previous critique.

4. Intergovernmental Review

    This funding opportunity is not subject to Executive Order 12372, 
``Intergovernmental Review of Federal Programs.'' A State approval is 
not required.

5. Funding Restrictions

    Grantees are allowed a reasonable period of time in which to submit 
required financial and performance reports.
    Failure to submit required reports within the time allowed may 
result in suspension or termination of an active grant, withholding of 
additional awards for the project, or other enforcement actions such as 
withholding of payments or converting to the reimbursement method of 
payment. Continued failure to submit required reports may result in the 
imposition of special award provisions, or cause other eligible 
projects or activities involving that grantee organization, or the 
individual responsible for the delinquency to not be funded.
    Failure to obtain prior approval for change in Scope, Principal 
Investigator, Grantee Institutions, Successor in Interest, or Recipient 
Institute Name, undertaking any activities disapproved or restricted as 
a condition of the award, may result in fund restrictions.
Allowable Administrative Cost
    Certain administrative costs for managing a comprehensive program 
are allowable and may vary, depending upon the size and complexity of 
the program's activities. The costs budgeted for NARCH grants and 
subcontracts may not duplicate items already budgeted in other cost 
centers of the AI/AN, research-intensive, and subcontracted 
organizations and institutions, such as accounts which make up the 
Facilities and Administration (F&A) cost pool. The grantee organization 
receiving the award must be prepared to provide documentation showing 
the direct relationship of proposed costs to the program, and that 
costs of this type are charged in a uniform manner to all other grants 
at all institutions and organizations participating in the award.

 Salary (up to 25 percent effort, although it should 
generally be less) for the NARCH Program Director is allowable for that 
portion of time or effort specifically employed in directing the 
proposed NARCH. (The 25 percent limit does not include salary for being 
a research investigator.) Limited salary support for secretarial or 
clerical help is

[[Page 8465]]

allowable only when in direct support of the proposed NARCH. For 
guidance, applicants should refer to the OMB Circular appropriate for 
them, A-87 (Cost Principles for State, local, and Indian Tribal 
Governments), at http://www.whitehouse.gov/omb/circulars or A-122 (Cost 
Principles for Non-Profit Organizations), http://www.whitehouse.gov/omb/circulars, or should contact the grants management officer under 
INQUIRIES.
 Costs for evaluation activities are allowable, as 
are costs for the Community and Scientific Advisory Council. All 
applications must include costs associated with one annual meeting per 
year in Rockville, MD, of NARCH directors and their key scientific 
personnel.
 Student Development Costs. Student (graduate, 
undergraduate, and high school, if well justified) remuneration through 
salary/wages for participation in research experiences may be 
requested, provided all the following conditions are met:
     The student is performing necessary work 
involved in the research.
     There is an employer-employee relationship 
between the student and the proposed NARCH or its partners. The total 
compensation is reasonable for the work performed.
     It is the practice of the proposed NARCH or its 
partners to provide compensation for all students in similar 
circumstances, regardless of the source of support for the activity.
    Graduate students, but not undergraduate students, are allowed 
tuition costs as part of a compensation package. When requesting 
support for a graduate student, the NARCH application should provide, 
in the budget justification section of the application, the basis for 
the compensation level. The IHS staff will review the requested 
compensation level and, if it is reasonable and justified, will provide 
compensation up to a maximum of $45,000 (http://grants.nih.gov/grants/guide/notice-files/not98-168.html). Post-doctoral students should be 
compensated at a rate commensurate with that of other post-doctoral 
employees with similar degrees and experience at the research-intensive 
institution.
    It is the expectation of the IHS, NIGMS and AHRQ that students who 
are enrolled in an accredited graduate program, as part of a proposed 
NARCH, will not be excluded from support from other non-federal or 
federal graduate training sources (such as loans and assistance under 
the Veterans' Adjustment Benefit Act or Pell Grants) for which they are 
eligible. Graduate and post-doctoral students cannot concurrently hold 
another federally-sponsored stipend or fellowship or any other federal 
award that duplicates the NARCH support.
 Faculty/Researcher Development Costs. Costs to 
support faculty/researcher development activities, such as workshops or 
courses, national meetings, or short-term research experiences in the 
laboratory of an active NIH-extramurally-funded researcher needed for 
acquiring specific skills or methodologies needed for prospective 
research, are allowable. Such costs might include tuition, travel and 
per diem costs, as well as salary support appropriate to the percent 
effort needed for the activity. Also, allowable are costs such as 
travel and per diem associated with short-term research experiences in 
the laboratory of an active extramurally funded researcher.
 Research Project Costs. Direct costs associated with 
research and pilot research projects are allowable when adequate 
justification is provided. These include faculty/researcher salaries, 
reimbursed according to percent effort. Summer salary support can be 
paid provided the institution's academic schedule permits such release 
and when the institution approves. The maximum summer-salary support 
provided by the program cannot exceed the equivalent of three months at 
100 percent effort, or time specified by the institution as its policy. 
Grant funds may not be used to increase or supplement faculty/
researcher academic year salaries. Salary support for technical 
assistance and costs for consultants, if justified, are allowable. 
Costs for equipment to be used to carry out the proposed research are 
allowable.
 Costs for Core Scientific Services. Costs for core 
scientific services to support two or more projects are allowable. 
Costs for multi-user research equipment are also allowable. A plan for 
access to the multi-user equipment, its maintenance, management and use 
must be included. To aid in the review, it is suggested that a tabular 
summary show the estimated or actual proportional use of this equipment 
by each project, and other investigators and students. Justify this 
core component by discussing ways in which these centralized services 
improve quality, bring about an economy of effort, and/or save overall 
costs as compared to their inclusion as part of each research project. 
Personnel costs to maintain and service the equipment are an allowable 
cost. Support for very large pieces of equipment, however, may be 
restricted by the NARCH budget. Plans to maintain the shared core 
scientific services and facility beyond the grant period should be 
discussed.
 Cost for Supplies. Costs for supplies, including 
costs for animals, necessary to carry out the proposed research may be 
included. Travel costs for the investigator(s) are permitted when 
direct benefits to the program are expected, and when adequate 
justification is provided. Alterations and Renovations costs (up to 
$40,000) are allowable only when essential for conduct of the proposed 
research. Other permitted costs include animal maintenance (unit care 
costs and number of care days), donor fees, publication costs, computer 
charges, rentals and leases, equipment maintenance, and service 
contracts.
 Consortium and Contract Arrangements. Consortium 
arrangements that may involve personnel costs, supplies, and other 
allowable costs, including F & A costs; contractual costs for support 
services, such as the laboratory testing of biological materials, 
clinical services, data processing, or core administrative services, 
are allowable expenses. Consortia and contractual costs with Native 
health organizations, tribes and/or research institutions in Canada are 
allowable expenses.
 Pilot Research Projects. The intent of pilot 
research projects is to lead to regular research projects funded as 
part of the center grant or as freestanding grants. For pilot research 
projects, applications may request support for up to $50,000 (direct 
costs) per year. This support is non-renewable.
 Subcontracts. The grant recipient may issue 
subcontracts to other organizations (such as the research-intensive 
institution of the partnership), as long as at least 30 percent of the 
grant remains with the AI/AN organization; that is, no more than 70 
percent may be subcontracted.

    F. Unallowable Costs: Unallowable costs for research projects 
(including for pilots projects) include costs for student development, 
textbooks, journals, memberships, and Internet subscription costs, as 
well as other costs prohibited by OMB Circulars A-87 or A-122 as 
applicable. Employees of the applicant organization may not serve as 
paid consultants but may be paid.

[[Page 8466]]

    The pilot research project is intended for faculty/researcher 
without current research support. Therefore, investigators with 
significant current support from other mechanisms such as the R01 and 
research funding from other extramural sources are not eligible, and 
the costs therefore are not allowable. Release time for preparing 
proposals or mini-research projects, not submitted, as pilot projects, 
is not allowed.

6. Other Submission Requirement

    The administrative personnel, facilities, and programs of the 
overall NARCH should be described. It is permissible, but not necessary 
to have a set of core support programs that provide common scientific 
services to two or more NARCH projects.
    Submit a typed and signed original application, including the 
Checklist, and one (1) single-sided photocopy of the entire application 
(including Appendices and supporting documents) in one package to: 
Grants Management Branch, Indian Health Service, Reyes Building, 801 
Thompson Avenue, Rockville, MD 20852-1627 (zip code is unchanged for 
express/courier services), Telephone: (301) 443-5204.
    Also, at the time of submission, send four (4) additional single-
sided photocopied and signed applications, including the Checklist, 
Appendices, and supporting documentation to: Center for Scientific 
Review, National Institutes of Health, 6701 Rockledge Drive, Room 6160-
-MSC 7892, Bethesda, MD 20892-7720, Bethesda, MD 20817 (for express or 
courier service). Telephone: (301) 594-7945.

V. Application Review Information

    Upon receipt, IHS and NIH staff will administratively review 
applications for completeness and responsiveness. Applications that are 
incomplete, non-responsive to this RFA, or do not follow the guidelines 
of the PHS form 398 (updated 09/09/03) or of the supplementary 
instructions for NARCH grants, will be returned to the applicant 
without further consideration.
    Applications will be evaluated in accordance with the criteria 
stated below for scientific and technical merit by appropriate peer 
review groups convened by the CSR. The National Advisory General 
Medical Sciences Council will conduct the second level of review.

1. Criteria

    Priorities for funding will be based on the scientific and 
technical merit of the application, the assessed potential of 
investigators in the developmental stages of their careers, and the 
likelihood that the proposed NARCH can further the purposes of the 
NARCH initiative. Awards will be made only to organizations with 
financial management systems and management capabilities that are 
acceptable under PHS policy. Awards will be administered under the PHS 
Grants Policy Statement.

2. Review and Selection Process

    A. Review of Student and Faculty/Researcher Development Plans: The 
anticipated effectiveness of the proposed NARCH in making a difference 
relative to the current base-line data (based in part on previous 
experience of the partners) will be assessed. Factors to be considered 
include:

 The appropriateness of the content, phasing, 
quality, and duration of the student or faculty/researcher development 
plans in the NARCH application to achieve the scientific development of 
the faculty/researcher, post-doctoral, pre-doctoral, undergraduate, and 
(if well justified) high school students; and
 The experience, proposed commitment, and quality of 
the mentoring plan and of individual mentors of the partners in 
providing mentoring, guidance, and advice to candidates (including 
training in responsible conduct of research and research integrity, 
teaching, and protection of human subjects), and in fostering the 
development of academic and community-based AI/AN researchers.

    B. Review of Research Projects: The NIH has announced procedures to 
be used for the review of research grant applications (NIH Guide, 
Volume 26, Number 22, June 27, 1997 or see http://grants.nih.gov/grants/guide/notice-files/not97-010.html html). For NARCH applications, the 
five criteria listed in this announcement will be used for the 
scientific review of research projects and pilot research projects. The 
review of research projects and pilot research projects will be the 
same except that applications for pilot studies may be smaller in scope 
and would not be expected to have preliminary data.
    The purposes of the NARCH initiative are:

 To develop a cadre of AI/AN scientists and health 
professionals engaged in biomedical, behavioral and health services 
research;
 To increase the formation of partnerships between 
AI/AN and research-intensive institutions; and
 To encourage competitive research that address the 
health priorities and health disparities in the AI/AN population.

    In the written comments, reviewers will be asked to discuss the 
following aspects of the application in order to judge the likelihood 
that the proposed research will have a substantial impact on the 
pursuit of these purposes. Each of these criteria will be addressed and 
considered in assigning the overall score, weighting them as 
appropriate for each application.

 Significance: Does this study address an important 
problem? If the aims of the application are achieved, how will 
scientific knowledge be advanced? What will be the effect of these 
studies on the concepts or methods that drive this field?
 Approach: Are the conceptual framework, design, 
methods, and analyses adequately developed, well-integrated, and 
appropriate to the aims of the project? Does the application 
acknowledge potential problem areas and consider alternative tactics? 
For pilot research projects, are the proposed aims reasonable, and is 
there potential to lead to more substantial funding?
 Innovation: Does the project employ novel concepts, 
approaches, or methods? Are the aims original and innovative? Does the 
project challenge existing paradigms or develop new methodologies or 
technologies?
 Investigator: Is the investigator appropriately 
trained and well suited to carry out this work? Is the work proposed 
appropriate to the experience level of the principal investigator and 
other researchers (if any)?
 Environment: Does the scientific environment in 
which the work will be done contribute to the probability of success? 
Do the proposed experiments take advantage of unique features of the 
scientific environment or employ useful collaborative arrangements? Is 
there evidence of institutional support?

    In addition to the above criteria, in accordance with NIH policy, 
all applications will also be reviewed with respect to the following:

 The adequacy of plans, if research on human subjects 
is involved, to include both genders and children as appropriate for 
the scientific goals of the research. Plans for the recruitment and 
retention of subjects will also be evaluated.
 The reasonableness of the proposed budget and 
duration in relation to the proposed research.
 The adequacy of the proposed protection for humans, 
animals or the

[[Page 8467]]

environment, to the extent they may be adversely affected by the 
project proposed in the application.
 The adequacy of the proposed plan to share data, if 
appropriate.

    In reviewing the overall Center, the initial scientific review 
group will examine evidence of the partners' commitment to the purposes 
of the NARCH initiative to develop a cadre of AI/AN scientists and 
health professionals engaged in biomedical, clinical, behavioral and 
health services research that is competitive for NIH funding; to 
increase the capacity of both research-intensive institutions and AI/AN 
organizations to work in partnership to reduce distrust by AI/AN 
communities and people toward research; and to encourage competitive 
research linked to the health priorities of the AI/AN partner and to 
reducing health disparities. The evidence will include:

 The quality of the partnership of the institutional 
and community partners, and the quality of the involvement of the 
Community and Scientific Advisory Council, as demonstrated by 
documentation of (for instance): the intellectual and tangible 
contributions and activities of the partners, and of the Council, in 
developing the application and the proposed NARCH; the interactions of 
the partners, and of the members of the Council, in meetings (such as 
those to develop the application and proposed NARCH); the past 
activities and future plans to increase the capacity of the partners 
and of the Council; the plans for future contributions and activities 
by the partners, and by the Council, in furthering the goals of the 
proposed NARCH; and the plans for future development of the partnership 
itself;
 The experience and commitment of the institutional 
and community partners to recruit, retain, and advance AI/AN faculty/
researcher and students, to support faculty/researcher and student 
research efforts, and to increase the role of the involved AI/AN 
communities in the plans of the proposed NARCH;
 The appropriateness of the plan for evaluating the 
impact of the proposed NARCH, including the quality of baseline data 
and milestones for accomplishments, and a system to track the future 
course of program participants; and
 The potential of the proposed NARCH to be a regional 
and national resource, including: Capacity to provide quality research 
training and mentoring for integrated promotion and development of AI/
AN research careers from undergraduate (or if well justified, high 
school) through post-doctoral levels; attainment of quality research 
linked to health priorities of the AI/AN partner and to reducing health 
disparities; plans for research information dissemination and education 
activities; and plans for the development of research networks to 
support the scientific aims of the proposed NARCH.

3. Anticipated Announcement and Award Dates

    Anticipated Announcement Date: March 15, 2004.
    Anticipated Award Date: May 1, 2005.

VI. Award Administration Information

1. Award Notices

    Grants Management will not award a grant without an approved 
application in conformance with regulatory and policy requirements and 
which describes the purpose and scope of the project to be funded. When 
the application is approved for funding, the Grants Management Office 
will prepare a Notice of Grant Award with special terms and conditions 
binding upon the award and refer to all general terms applicable to the 
award.

2. Administrative and National Policy Requirements

    A. Inclusion of Women and Minorities in Research Involving Human 
Subjects: It is the policy of the NIH that women and members of 
minority groups and their subpopulations must be included in all NIH 
supported biomedical, clinical, behavioral and health services research 
projects involving human subjects, unless a clear and compelling 
rationale and justification is provided that inclusion is inappropriate 
with respect to the health of the subjects or the purpose of the 
research. This policy results from the NIH Revitalization Act of 1993 
(Section 492B of P.L. 103-43). Because the NARCH initiative targets AI/
AN people and communities, a minority population, only the policy of 
inclusion of women applies to this RFA. The IHS has fully accepted the 
OHRP policy regarding human subjects. The OHRP Web site is http://ohrp.osophs.dhhs.gov/g-topics.htm.
    All investigators proposing research involving human subjects 
should read the UPDATED ``NIH Guidelines For Inclusion of Women and 
Minorities as Subjects in Clinical Research,'' published in the NIH 
Guide for Grants and Contracts on August 2, 2000 (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html). The 
complete Guidelines are available at http://grants1.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. The revisions 
relate to NIH defined Phase III clinical trials and require:

 All applications or proposals and/or protocols to 
provide a description of plans to conduct analyses, as appropriate, to 
address differences by sex/gender and/or racial/ethnic groups, 
including subgroups if applicable; and
 All investigators to report accrual, and to conduct 
and report analyses, as appropriate, by sex/gender and/or racial/ethnic 
group differences.

    B. Inclusion of Children as Participants in Research Involving 
Human Subjects: It is the policy of NIH that children (i.e., 
individuals under the age of 21) must be included in all human 
subjects' research, conducted or supported by the NIH, unless there are 
scientific or ethical reasons not to include them. This policy applies 
to all initial (Type 1) applications submitted.
    All investigators proposing research involving human subjects 
should read the ``NIH Policy and Guidelines on the Inclusion of 
Children as Participants in Research Involving Human Subjects'' that 
was published in the NIH Guide for Grants and Contracts, March 6, 1998, 
and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html. Investigators may obtain 
copies of these policies from the initiative staff listed under 
INQUIRIES. Initiative staff may also provide additional relevant 
information concerning the policy.
    C. URLS in NIH Grant Applications or Appendices: All applications 
and proposals for NIH funding must be self-contained within specified 
page limitations. Unless otherwise specified in an NIH solicitation, 
Internet addresses (URLs) should not be used to provide information 
necessary to the review because reviewers are under no obligation to 
view the Internet sites. Reviewers are cautioned that their anonymity 
may be compromised when they directly access an Internet site.
    D. Public Access to Research Data Through the Freedom of 
Information Act: The OMB Circular A-110 has been revised to provide 
public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances. Data that are:

 First produced in a project that is supported in 
whole or in part with Federal funds; and
 Cited publicly and officially by a Federal agency in 
support of an action that has the force and effect of law

[[Page 8468]]

(i.e., a regulation) may be accessed through FOIA.
    It is important for applicants to understand the basic scope of 
this amendment. NIH has provided guidance at: http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.
    Applicants may wish to place data collected under this PA in a 
public archive, which can provide protections for the data and manage 
the distribution for an indefinite period of time. If so, the 
application should include a description of the archiving plan in the 
study design and include information about this in the budget 
justification section of the application. In addition, applicants 
should think about how to structure informed consent statements and 
other human subjects procedures given the potential for wider use of 
data collected under this award.
    E. Allowable Administrative Cost: Certain administrative costs for 
managing a comprehensive program are allowable and may vary, depending 
upon the size and complexity of the program's activities. The costs 
budgeted for NARCH grants and subcontracts may not duplicate items 
already budgeted in other cost centers of the AI/AN, research-
intensive, and subcontracted organizations and institutions, such as 
accounts which make up the Facilities and Administration (F&A) cost 
pool. The grantee organization receiving the award must be prepared to 
provide documentation showing the direct relationship of proposed costs 
to the program, and that costs of this type are charged in a uniform 
manner to all other grants at all institutions and organizations 
participating in the award.

 Salary (up to 25 percent effort, although it should 
generally be less) for the NARCH Program Director is allowable for that 
portion of time or effort specifically employed in directing the 
proposed NARCH. (The 25 percent limit does not include salary for being 
a research investigator.) Limited salary support for secretarial or 
clerical help is allowable only when in direct support of the proposed 
NARCH. For guidance, applicants should refer to the OMB Circular 
appropriate for them, A-87 (Cost Principles for State, local, and 
Indian Tribal Governments), at http://www.whitehouse.gov/omb/circulars 
or A-122 (Cost Principles for Non-Profit Organizations), http://www.whitehouse.gov/omb/circulars, or should contact the grants 
management officer under INQUIRIES.
 Costs for evaluation activities are allowable, as 
are costs for the Community and Scientific Advisory Council. All 
applications must include costs associated with one annual meeting per 
year in Rockville, MD, of NARCH directors and their key scientific 
personnel.
 Student Development Costs. Student (graduate, 
undergraduate, and high school if well justified) remuneration through 
salary/wages for participation in research experiences may be 
requested, provided all the following conditions are met:
     The student is performing necessary work 
involved in the research.
     There is an employer-employee relationship 
between the student and the proposed NARCH or its partners. The total 
compensation is reasonable for the work performed.
     It is the practice of the proposed NARCH or its 
partners to provide compensation for all students in similar 
circumstances, regardless of the source of support for the activity.

    Graduate students, but not undergraduate students, are allowed 
tuition costs as part of a compensation package. When requesting 
support for a graduate student, the NARCH application should provide, 
in the budget justification section of the application, the basis for 
the compensation level. The IHS staff will review the requested 
compensation level and, if it is reasonable and justified, will provide 
compensation up to a maximum of $45,000 (http://grants.nih.gov/grants/guide/notice-files/not98-168.html). Post-doctoral students should be 
compensated at a rate commensurate with that of other post-doctoral 
employees with similar degrees and experience at the research-intensive 
institution.
    It is the expectation of the IHS, NIGMS and AHRQ that students who 
are enrolled in a accredited graduate program, as part of a proposed 
NARCH, will not be excluded from support from other non-Federal or 
Federal graduate training sources (such as loans and assistance under 
the Veterans' Adjustment Benefit Act or Pell Grants) for which they are 
eligible. Graduate and post-doctoral students cannot concurrently hold 
another federally-sponsored stipend or fellowship or any other Federal 
award that duplicates the NARCH support.

 Faculty/Researcher Development Costs. Costs to 
support faculty/researcher development activities, such as workshops or 
courses, national meetings, or short-term research experiences in the 
laboratory of an active NIH-extramurally-funded researcher needed for 
acquiring specific skills or methodologies needed for prospective 
research, are allowable. Such costs might include tuition, travel and 
per diem costs, as well as salary support appropriate to the percent 
effort needed for the activity. Also, allowable are costs such as 
travel and per diem associated with short-term research experiences in 
the laboratory of an active extramurally funded researcher.
 Research Project Costs. Direct costs associated with 
research and pilot research projects are allowable when adequate 
justification is provided. These include faculty/researcher salaries, 
reimbursed according to percent effort. Summer salary support can be 
paid provided the institution's academic schedule permits such release 
and when the institution approves. The maximum summer-salary support 
provided by the program cannot exceed the equivalent of three months at 
100 percent effort, or time specified by the institution as its policy. 
Grant funds may not be used to increase or supplement faculty/
researcher academic year salaries. Salary support for technical 
assistance and costs for consultants, if justified, are allowable. 
Costs for equipment to be used to carry out the proposed research are 
allowable.
 Costs for Core Scientific Services. Costs for core 
scientific services to support two or more projects are allowable. 
Costs for multi-user research equipment are also allowable. A plan for 
access to the multi-user equipment, its maintenance, management and use 
must be included. To aid in the review, it is suggested that a tabular 
summary show the estimated or actual proportional use of this equipment 
by each project, and other investigators and students. Justify this 
core component by discussing ways in which these centralized services 
improve quality, bring about an economy of effort, and/or save overall 
costs as compared to their inclusion as part of each research project. 
Personnel costs to maintain and service the equipment are an allowable 
cost. Support for very large pieces of equipment, however, may be 
restricted by the NARCH budget. Plans to maintain the shared core 
scientific services and facility beyond the grant period should be 
discussed.
 Cost for Supplies. Costs for supplies, including 
costs for animals, necessary to carry out the proposed research may be 
included. Travel costs for the investigator(s) are permitted when 
direct benefits to the program are

[[Page 8469]]

expected, and when adequate justification is provided. Alterations and 
Renovations costs (up to $40,000) are allowable only when essential for 
conduct of the proposed research. Other permitted costs include animal 
maintenance (unit care costs and number of care days), donor fees, 
publication costs, computer charges, rentals and leases, equipment 
maintenance, and service contracts.
 Consortium and Contract Arrangements. Consortium 
arrangements that may involve personnel costs, supplies, and other 
allowable costs, including F&A costs; contractual costs for support 
services, such as the laboratory testing of biological materials, 
clinical services, data processing, or core administrative services, 
are allowable expenses. Consortia and contractual costs with Native 
health organizations, tribes and/or research institutions in Canada are 
allowable expenses.
 Pilot Research Projects. The intent of pilot 
research projects is to lead to regular research projects funded as 
part of the center grant or as freestanding grants. For pilot research 
projects, applications may request support for up to $50,000 (direct 
costs) per year. This support is non-renewable.
 Subcontracts. The grant recipient may issue 
subcontracts to other organizations (such as the research-intensive 
institution of the partnership), as long as at least 30 percent of the 
grant remains with the AI/AN organization; that is, no more than 70 
percent may be subcontracted.
    F. Unallowable Costs: Unallowable costs for research projects 
(including for pilots projects) include costs for student development, 
textbooks, journals, memberships, and Internet subscription costs, as 
well as other costs prohibited by OMB Circulars A-87 or A-122 as 
applicable. Employees of the applicant organization may not serve as 
paid consultants but may be paid.
    The pilot research project is intended for faculty/researcher 
without current research support. Therefore, investigators with 
significant current support from other mechanisms such as the R01 and 
research funding from other extramural sources are not eligible, and 
the costs therefore are not allowable. Release time for preparing 
proposals or mini-research projects, not submitted, as pilot projects, 
is not allowed.
    G. Qualifications of the NARCH Program Director and Key Personnel: 
As leader of the research and research training for the proposed NARCH, 
the NARCH Program Director is expected to possess certain essential 
qualifications such as:

 Strong leadership skills, including scientific 
leadership experience and a strong academic and scientific background, 
as exemplified, ideally, by scientific publications and a record of 
peer-reviewed scientific support;
 The knowledge of and personal working relationship 
with the AI/AN Tribes or communities involved in the NARCH research, 
and with the partners of the proposed NARCH;
 Strong mentoring and supervision skills, to exercise 
responsibility for mentoring activities, organization of communicating 
skills programs, special methods workshops, tracking of student career 
plans, etc.; and
 Knowledge of IHS and NIH policies, including those 
concerning human participants in research, human biological material, 
animals, hazardous materials, and Tribal review and approval of 
research.
    The names and qualifications of the NARCH Program Director, the 
Student and Faculty/Researcher Development Director and directors of 
individual projects within the program (where appropriate), and any 
other key personnel, should be listed in the application under the Key 
Personnel section. Biographical Sketches of these individuals, 
including other grant support, should be included.

3. Reporting

    The NARCH Program Office and the Grants Management have 
requirements for the progress reports and financial reports based on 
the terms and conditions of the grant. Grantees are responsible and 
accountable for accurate reporting of the Progress Reports and 
Financial Status Reports which are generally due annually. Financial 
Status Report (SF 269) are due 90 days after each budget period and the 
final SF 269 must be verified from the grantee records on how the value 
was derived.
    Grantees are allowed a reasonable period to time in which to submit 
required financial and performance reports.
    Failure to submit required reports within the time allowed may 
result in suspension or termination of an active grant, withholding of 
additional awards for the project, or other enforcement actions such as 
withholding of payments or converting to the reimbursement method of 
payment. Continued failure to submit required reports may result in the 
imposition of special award provisions, or cause other eligible 
projects or activities involving that grantee organization, or the 
individual responsible for the delinquency to not be funded.
    Failure to obtain prior approval for change in Scope, Principal 
Investigator, Grantee Institutions, Successor in Interest, or Recipient 
Institute Name, undertaking any activities disapproved or restricted as 
a condition of the award, may result in fund restrictions.

VII. Agency Contact(s)

    1. Questions on the initiative, regarding IHS NARCH issues and 
policies, may be directed to: Alan Trachtenberg, M.D., M.P.H., Research 
Program Director, Indian Health Service, 801 Thompson Avenue, TMP, 
Suite 450, Rockville, MD 20852-1750, Telephone: (301) 443-0222, Fax: 
(301) 443-1522, e-mail: [email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Sylvia Ryan, Grants Management Branch, Indian Health 
Service, Reyes Building, 801 Thompson Avenue, Rockville, MD 20852-1627, 
Telephone: (301) 443-5204, Fax: (301) 443-9602, e-mail: 
[email protected].
    3. Questions on NIGMS issues and policies, may be directed to: 
Clifton A. Poodry, Ph.D., Minority Opportunities in Research Division, 
National Institute of General Medical Sciences, 45 Center Drive, Suite 
2AS.37, MSC 6200, Bethesda, MD 20892-6200, Telephone: (301) 594-3900, 
Fax: (301) 480-2753, e-mail: [email protected].
    4. Questions on the review of Applications may be directed to: 
Michael R. Martin, Ph.D., Director, Division of Physiological Systems, 
Center for Scientific Review, MSC 7892, Room 6160, 6701 Rockledge 
Drive, Bethesda, MD 20892-7892, Telephone: (301) 594-7945, Fax: (301) 
480-2065, e-mail: [email protected].
    5. Questions on Health Services Research and AHRQ policies may be 
directed to: Wendy Perry, Office of the Director, Agency for Healthcare 
Research and Quality, Room 3012, 540 Gaither Road, Rockville, MD 20850, 
Telephone: (301) 427-1216, Fax: (301) 427-1210, e-mail: 
[email protected].

VIII. Other Information

1. Healthy People 2010

    The Public Health Service (PHS) is committed to achieving the 
health promotion and disease prevention objectives of ``Healthy People 
2010'', a PHS led national activity for setting priority areas. This 
Request for Application (RFA) announcement is related to one or more of 
the priority areas. Potential applicants may obtain a

[[Page 8470]]

copy of ``Healthy People 2010'' at http://www.health.gov/healthypeople/.

2. Technical Assistance Workshop

    The IHS and NIH intend to conduct technical assistance and 
information sharing workshops about this grant initiative in March, and 
May, 2004 in at least two regional centers. Potential grantees wanting 
to attend one of these workshops will have to provide names and the 
eligible organization to Ms. Sylvia Ryan, at telephone number (301) 
443-5204 or Fax (301) 443-9602, or by e-mail to [email protected] as 
soon as possible and no later than March 15, 2004. This notification 
will help the IHS and the NIH to determine the best times and locations 
for potential grantees' training and to have adequate workshop 
supplies. The details of the workshops and locations will be posted (as 
they are finalized) on the IHS Research Program Web site at http://www.ihs.gov/medicalprograms/research.

3. Context

    The AI/AN Tribal nations and communities have long experienced 
poorer health status than other Americans. Although major gains of 
reducing health disparities were made in the last half of the twentieth 
century, most gains stopped by the mid 1980s (Trends in Indian Health 
1998-99) and a few diseases, e.g., diabetes, worsened. ``All Indian'' 
rates contain marked variation among the ``IHS Areas'' or regions 
(Regional Differences in Indian Health 1998-99); variation by Tribe 
exists within Areas as well. The Trends and Regional Differences 
reference can be found at the IHS website at http://www.ihs.gov/publicInfo/publications/index.asp. Although the ``All Indian'' 
mortality rates for all cancers are about 20 percent lower than the 
U.S. rates for all races, there is variation among IHS Areas for 
specific cancers; moreover, the favorable AI/AN mortality rates for 
some cancers may be due to markedly lower incidence rates partly offset 
by higher case-fatality rates. Unfamiliarity with modern health care 
may adversely influence health status among the elderly, the low-income 
elderly, and Tribes, and also may reduce the acceptability of health 
research among them. The daunting tasks confronting Tribes, 
researchers, and health care and public health programs in the 
beginning of the twenty-first century are to resume the reduction of 
health disparities that had occurred up to the 1980s, to reverse the 
worsening in a few diseases, to maintain and strengthen the favorable 
status, and to reduce the disparities among and within Areas and 
Tribes.
    Factors known to contribute to health status and disparities are 
complex, and include underlying biology, physiology, and genetics, as 
well as ethnicity, culture, socioeconomic status, gender/sex, age, 
geographical access to care, and levels of insurance. Additional 
factors known to contribute to health status and disparities include: 
family, home, and work environments; general or culturally specific 
health practices; social support systems; lack of access to culturally-
appropriate health care; and attitudes toward health. Yet none of these 
alone or in combination accounts for all documented differences.
    Health disparities of AI/ANs may also reflect a lack of research 
relevant to improve their health status. Many AI/ANs distrust research 
for historical reasons. One approach that combats this distrust is to 
ensure that Tribes are senior partners in training and research that 
involves them, as for example in community-based participatory 
research. This approach is especially helpful to design both training 
relevant to researchers from Tribal communities, and research relevant 
to the health needs of the communities.
    The mission of NIH is to acquire new knowledge that will lead to 
better health by understanding the processes underlying health and 
disease that in turn will help prevent, detect, diagnose, and treat 
disease and disability. The NARCH initiative works toward the NIH 
mission by supporting research that discovers the interrelationships 
among the many factors that contribute to health and disease, and by 
helping train and promote researchers concerned with AI/AN health.
    The Agency for Healthcare Research and Quality (AHRQ), formerly the 
Agency for Health Care Policy and Research (AHCPR), a component of the 
U.S. Department of Health and Human Services, is the Federal 
Government's focal point for research to improve the quality, safety, 
efficiency, and effectiveness of health care for all Americans. AHRQ 
accomplishes this mission through the establishment of a broad base of 
scientific research to: (1) Improve clinical practice, (2) improve the 
health care system's ability to provide access to and deliver high 
quality, high-value health care, and (3) provide policymakers with the 
ability to assess the impact of system changes on outcomes, quality, 
access to, cost, and use of health care services. An important element 
in AHRQ's portfolio is research (including demonstrations) that 
identifies successful strategies for translating evidence into 
sustainable improvements in clinical practice and outcomes.

4. IHS Research Program Objectives

    Due to the complexity of factors contributing to the health and 
disease of AI/ANs, and to their health disparities compared with other 
Americans, the collaborative efforts of the agencies of the Department 
of Health and Human Services, and the collaboration of researchers and 
AI/AN communities, are needed to achieve significant improvements in 
the health status of AI/AN people. To accomplish this goal, in addition 
to objectives set by the Tribe, Tribal Organization or Indian Health 
Board, the NARCH will pursue the following program objectives:
    A. To develop a cadre of AI/AN scientists and Health Professionals-
-Offering opportunities to develop more AI/AN scientists and health 
professionals engaged in research, and to conduct biomedical, clinical, 
behavioral and health services research that is responsive to the needs 
of the AI/AN community and the goals of this initiative; Faculty/
researchers and students at each proposed NARCH will develop 
investigator-initiated, scientifically meritorious research projects, 
including pilot research projects, and will be supported through 
science education projects designed to increase the numbers of, and to 
improve the research skills of, investigators involved with AI/ANs.
    B. To enhance Partnerships--Recent community-based participatory 
research suggests that AI/AN communities can work collaboratively in 
partnership with health researchers to further the research needs of 
AI/ANs. Fully utilizing all cultural and scientific knowledge, 
strengths, and competencies, such partnerships can lead to better 
understanding of the biological, genetic, behavioral, psychological, 
cultural, social, and economic factors either promoting or hindering 
improved health status of AI/ANs, and generate the development and 
evaluation of interventions to improve their health status.
    C. To Reduce Health Disparities--In the amended Indian Health Care 
Improvement Act, Public Law (Pub. L.) 94-437, IHS was legislatively 
mandated to improve the delivery of effective health care to AI/ANs. In 
the NIH Revitalization Act of 1993, NIH was encouraged to increase the 
number of under-represented minorities participating in biomedical, 
clinical, behavioral and health services research, including studies on 
drug abuse and alcoholism, and the examination of the role of 
resiliency in the prevention and treatment of those conditions. Also, 
the ``Initiative to Eliminate Racial and

[[Page 8471]]

Ethnic Disparities in Health'' by HHS (http://raceandhealth.hhs.gov/) 
encouraged NIH to help reduce health disparities. In its 1999 
reauthorizing legislation, AHRQ was directed to conduct and support 
research to identify and reduce health care disparities (Pub. L. 106-
525). NIH published the ``Strategic Research Plan and Budget to Reduce 
and Ultimately Eliminate Health Disparities, Fiscal Years 2002-2006'' 
at (http://www.ncmhd.nih.gov). Finally, the ``NIGMS Strategic Plan for 
Reducing Health Disparities'' (http://www.nigms.nih.gov/news/reports/health_disparities.html) presents an NIGMS role in health disparity 
reduction through its focused programs on research infrastructure to 
increase the number and capabilities of under-represented minority 
health researchers. In response to these priorities, the IHS, NIGMS and 
AHRQ have established a collaboration to support Native American 
Research Centers for Health. Reducing health disparities among AI/AN 
communities and individuals may be fostered by greater understanding of 
how to enhance their strengths and resiliencies. While AI/AN 
communities have relied on health research and medical science to 
reduce health disparities, they also have relied on their own 
psychological, organizational, and cultural assets and strengths to 
survive major harms and disruptions over the centuries, and to rebound 
from insults to health. For research about resiliencies, see http://www.nida.nih.gov/ResilandRiskWG/ResilandRiskWG.html.

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White, R., Nabokov, P., Deloria, P.J. (Text by), Joseph, A.M. (Intro.) 
The Native Americans: An Illustrated History. Turner Publishing, Inc. 
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    Dated: February 17, 2004.
Michel E. Lincoln,
Deputy Director, Indian Health Service.
[FR Doc. 04-3867 Filed 2-23-04; 8:45 am]
BILLING CODE 4160-16-P