[Federal Register Volume 69, Number 112 (Thursday, June 10, 2004)]
[Notices]
[Pages 32574-32578]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-13141]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Expansion of Routine HIV Counseling & Testing and the Provision 
of Basic Care in Clinics and Hospitals in the Republic of Uganda

    Announcement Type: New.
    Funding Opportunity Number: 04229.
    Catalog of Federal Domestic Assistance Number: 93.941.
    Key Dates:
    Application Deadline: July 12, 2004.

I. Funding Opportunity Description

    Authority: This program is authorized under sections 301 and 307 
of the Public Health Service Act, [42 U.S.C. Sections 241 and 242l], 
and section 104 of the Foreign Assistance Act of 1961, 22 U.S.C. 
215lb, as amended.

    Purpose: The Centers for Disease Control and Prevention (CDC) 
announces the availability of fiscal year (FY) 2004 funds for a 
cooperative agreement program for the ``Expansion of Routine HIV 
Counseling & Testing and the provision of Basic Care Provision in 
Clinics and Hospitals in the Republic of Uganda''. This program 
addresses the ``Healthy People 2010'' focus area of HIV.
    The overall aim of this program is to develop models of routine HIV 
counseling and testing in clinics and hospitals in district settings 
that would either directly provide, or refer those testing positive to, 
sources of basic preventative and palliative care. The provision of 
antiretroviral (ARV) therapy is not part of this program.
    The United States Government seeks to reduce the impact of HIV/AIDS 
in specific countries within sub-Saharan Africa, Asia and the Americas. 
The President's Emergency Plan for AIDS Relief (PEPFAR) encompasses 
HIV/AIDS activities in more than 75 countries and focuses on 14 
countries including Uganda to develop comprehensive and integrated 
prevention, care and ARV treatment programs. CDC has initiated its 
Global AIDS Program (GAP) to strengthen capacity and expand activities 
in the areas of: (1) HIV primary prevention; (2) HIV care, support and 
treatment; and (3) capacity and infrastructure development, including 
surveillance. Targeted countries represent those with the most severe 
epidemics and the highest number of new infections. They also represent 
countries where the potential impact is greatest and where the United 
States government agencies are already active. Uganda is one of those 
countries.
    CDC's mission in Uganda is to work with Ugandan and international 
partners to develop, evaluate, and support effective implementation of 
interventions to prevent HIV and related illnesses and improve care and 
support of persons with HIV/AIDS.
    Voluntary counseling and testing (VCT) services are only available 
at 11 percent of health facilities (Uganda Health Facilities Survey 
2002). To date there has been no routine counseling and testing (RCT) 
within clinical settings. Where HIV testing services are available in 
clinical settings only selected patients (28 percent in a recent study) 
are referred for testing, and counseling support is generally poor or 
absent. In the same study, 55 percent of those not tested said they 
would have wanted to be tested. The most recent Demographic and Health 
Survey in Uganda indicated that 70 percent of people would like to 
receive HIV testing, but only ten percent reported that they had been 
tested. An estimated 20-70 percent of patients in hospital wards, TB 
clinics, and sexually transmitted infections (STI) clinics are HIV 
infected, but HIV testing is not currently part of routine care.
    The purpose of this program is to introduce RCT at hospitals or 
other clinically oriented institutions or programs providing services 
to a substantial portion of their surrounding population. The initial 
year would involve hospitals in two different districts and would 
result in roll-out in successive years to other districts. This program 
would focus its support to expand activities in future years to clinics 
and hospitals in other areas under-served by other VCT or RCT 
providers. The program would also support the capacity of the target 
hospitals and other local care providers to offer basic preventive care 
and palliative care by supporting appropriate training, networking, 
information exchange and planning, and when necessary, purchase of 
commodities, but without taking on principal responsibility for 
financial support of care provision.
    It is currently proposed that the basic preventive care package 
includes: (1) Cotrimoxazole prophylaxis; (2) active TB screening and 
treatment or INH prophylaxis; (3) a safe water vessel with chlorine 
solution; (4) an insecticide-treated bed-net (ITN); and (5) prevention 
with positives counseling (PWPC). The palliative care package would 
include pain management and psychosocial support in addition to the 
basic care package elements.
    The measurable outcomes of the program will be in alignment with 
goals of the GAP to reduce HIV transmission and improve care of persons 
living with HIV. They also will contribute to the PEPFAR goals, which 
are: (1) Within five years treat more than two million HIV-infected 
persons with effective combination anti-retroviral therapy; (2) care 
for seven million HIV-infected and affected persons including those 
orphaned by HIV/AIDS; and (3) prevent ten million new infections. 
Specific measurable outcomes of this program will be the number of 
clients receiving RCT and the percentage coverage of patients by RCT.
    Activities: Awardee activities for this program are as follows:
    a. Establish a project office(s) as required by the activities.
    b. Identify project staffing needs; hire and train staff.
    c. Identify furnishings, fittings, equipment, computers and other 
fixed assets procurement needs of the project and implementing partners 
and acquire from normal sources.
    d. Establish suitable administrative and financial management 
structures.
    e. Work with the Ministry of Health (MOH) and other stakeholders, 
as necessary, to develop RCT and care operational guidelines for 
hospitals and clinical settings.
    f. Support the partner hospitals and clinics to implement RCT in 
all hospital units including the outpatient departments. If 
appropriate, develop a strong referral system for those testing 
positive to organizations providing effective care.
    g. Train personnel from other clinical facilities in the same and 
neighboring under-served districts in conducting RCT.
    h. Carry out work site follow up to training within the target 
districts.
    i. Support the clinical facilities to develop a simple data 
collection system, integrated within the general Health Management 
Information System (HMIS) that reflects useful information specifically 
related to RCT activities including PEPFAR indicators.
    j. Ensure that the commodities supply & management system is 
operational in respect to test kits, cotrimoxazole, TB diagnostic 
materials and drugs, and medicines for pain management, using existing 
hospital and public sector systems as far as possible, and project 
emergency re-supply only as necessary.
    k. Publish reports, guidelines and training manuals relating to RCT 
testing in district clinical settings.
    l. Plan to recruit additional RCT sites for roll out of the project 
in years two to five.

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    m. Ensure that the above activities are undertaken in manner 
consistent with the national HIV/AIDS strategic framework.
    n. Monitor and evaluate project activities. In collaboration with 
the MOH and other stakeholders revise RCT guidelines based on 
evaluation findings as necessary.
    In a cooperative agreement, CDC staff is substantially involved in 
the program activities, above and beyond routine grant monitoring.
    CDC activities for this program are as follows:
    a. Provide technical assistance, as needed, in the development of 
training curricula, materials, and diagnostic therapeutic guidelines.
    b. Collaborate with the recipient, as needed, in the development of 
an information technology system for medical record keeping and 
information access and in the analysis of data derived from those 
records.
    c. Assist, as needed, in monitoring and evaluation of the program 
and in development of further appropriate initiatives.
    d. Provide input, as needed, into the criteria for selection of 
staff and training candidates, and the hospitals and clinics to be 
included in the program.
    e. Provide input into the overall program strategy.
    f. Collaborate, as needed, with the awardee in the selection of key 
personnel to be involved in the activities to be performed under this 
agreement, including approval of the overall manager of the program.
    Technical assistance and training may be provided directly by CDC 
staff or through organizations that have successfully competed for 
funding under a separate CDC contract.

II. Award Information

    Type of Award: Cooperative Agreement.
    CDC involvement in this program is listed in the Activities section 
above.
    Fiscal Year Funds: 2004.
    Approximate Total Funding: $2,330,000. (This amount is for the 
entire five-year project period.).
    Approximate Number of Awards: one.
    Approximate Average Award: $466,000. (This amount is for the first 
12-month budget period, and includes both direct and indirect costs.)
    Floor of Award Range: none.
    Ceiling of Award Range: $466,000.
    Anticipated Award Date: September 1, 2004.
    Budget Period Length: 12 months.
    Project Period Length: 5 years.
    Throughout the project period, CDC's commitment to continuation of 
awards will be conditioned on the availability of funds, evidence of 
satisfactory progress by the recipient (as documented in required 
reports), and the determination that continued funding is in the best 
interest of the Federal government.

III. Eligibility Information

III.1. Eligible Applicants

    Applications may be submitted by public nonprofit organizations, 
private nonprofit organizations, universities, colleges, research 
institutions, hospitals, and faith-based organizations that meet the 
following criteria:
    1. Have at least three years of documented HIV/AIDS-related 
clinical experience and/or HIV/AIDS counseling and testing experience 
in Uganda.
    2. Have agreements with the authorities representing the first two 
proposed hospital sites for operations of the program during the first 
year.
    3. Applicant organization must be based in Uganda.

III.2. Cost Sharing or Matching

    Matching funds are not required for this program.

III.3. Other

    If you request a funding amount greater than the ceiling of the 
award range, your application will be considered non-responsive and 
will not be entered into the review process. You will be notified that 
your application did not meet the submission requirements.
    If your application is incomplete or non-responsive to the 
requirements listed below, it will not be entered into the review 
process. You will be notified that your application did not meet the 
submission requirements.

    Note: Title 2 of the United States Code Section 1611 states that 
an organization described in Section 501(c)(4) of the Internal 
Revenue Code that engages in lobbying activities is not eligible to 
receive Federal funds constituting an award, grant or loan.

IV. Application and Submission Information

IV.1. Address to Request Application Package

    To apply for this funding opportunity use application form PHS 
5161. Application forms and instructions are available on the CDC web 
site, at the following Internet address: www.cdc.gov/od/pgo/forminfo.htm.
    If you do not have access to the Internet, or if you have 
difficulty accessing the forms on-line, you may contact the CDC 
Procurement and Grants Office Technical Information Management Section 
(PGO-TIM) staff at: (770) 488-2700. Application forms can be mailed to 
you.

IV.2. Content and Form of Submission

    Application: You must submit a project narrative with your 
application forms. Your narrative must be submitted in the following 
format:
     Maximum number of pages: 25. If your narrative exceeds the 
page limit, only the first pages which are within the page limit will 
be reviewed.
     Font size: 12 point unreduced.
     Double spaced.
     Paper size: 8.5 by 11 inches.
     Page margin size: One inch.
     Printed only on one side of page.
     Held together only by rubber bands or metal clips; not 
bound in any other way.
     Must be submitted in English.
    Your narrative should address activities to be conducted over the 
entire project period, and should consist of, as a minimum, in the 
order listed: a plan, objectives, activities, methods, an evaluation 
framework, a budget and budget justification highlighting any supplies 
mentioned in the Program Requirements and any proposed capital 
expenditure.
    Additional information is optional and may be included in the 
application appendices. The appendices will not be counted toward the 
narrative page limit. Additional information could include but is not 
limited to: organizational charts, curriculum vitae, letters of 
support, etc.
    The budget justification will not be counted in the page limit 
stated above.
    You are required to have a Dun and Bradstreet Data Universal 
Numbering System (DUNS) number to apply for a grant or cooperative 
agreement from the Federal government. The DUNS number is a nine-digit 
identification number, which uniquely identifies business entities. 
Obtaining a DUNS number is easy and there is no charge. To obtain a 
DUNS number, access www.dunandbradstreet.com or call 1-866-705-5711.
    For more information, see the CDC Web site at: http://www.cdc.gov/od/pgo/funding/pubcommt.htm.
    If your application form does not have a DUNS number field, please 
write your DUNS number at the top of the first page of your 
application, and/or include your DUNS number in your application cover 
letter.
    Additional requirements that may require you to submit additional 
documentation with your application are listed in section 
``Administrative and National Policy Requirements.''

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IV.3. Submission Dates and Times

    Application Deadline Date: July 12, 2004.
    Explanation of Deadlines: Applications must be received in the CDC 
Procurement and Grants Office by 4 p.m. Eastern Time on the deadline 
date. If you send your application by the United States Postal Service 
or commercial delivery service, you must ensure that the carrier will 
be able to guarantee delivery of the application by the closing date 
and time. If CDC receives your application 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, you will be given the opportunity to 
submit documentation of the carriers guarantee. If the documentation 
verifies a carrier problem, CDC will consider the application as having 
been received by the deadline.
    This announcement is the definitive guide on application submission 
address and deadline. It supersedes information provided in the 
application instructions. If your application does not meet the 
deadline above, it will not be eligible for review, and will be 
discarded. You will be notified that your application did not meet the 
submission requirements.
    CDC will not notify you upon receipt of your application. If you 
have a question about the receipt of your application, first contact 
your courier. If you still have a question, contact the PGO-TIM staff 
at: (770) 488-2700. Before calling, please wait two to three days after 
the application deadline. This will allow time for applications to be 
processed and logged.

IV.4. Intergovernmental Review of Applications

    Executive Order 12372 does not apply to this program.

IV.5. Funding Restrictions

    Restrictions, which must be taken into account while writing your 
budget, are as follows:
     Antiretroviral Drugs--The purchase of ARVs, reagents, and 
laboratory equipment for antiretroviral treatment projects (outside of 
PMTCT) require pre-approval from HHS/CDC officials.
     Needle Exchange--No funds appropriated under this Act 
shall be used to carry out any program of distributing sterile needles 
or syringes for the hypodermic injection of any illegal drug.
     Funds may be spent for reasonable program purposes, 
including personnel, training, travel, supplies and services. Equipment 
may be purchased and renovations completed 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 (WHO), 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 organization 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 and care 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.
     Prostitution and Related Activities.
    The U.S. Government is opposed to prostitution and related 
activities, which are inherently harmful and dehumanizing, and 
contribute to the phenomenon of trafficking in persons.
    Any entity that receives, directly or indirectly, U.S. Government 
funds in connection with this document (``recipient'') cannot use such 
U.S. Government funds to promote or advocate the legalization or 
practice of prostitution or sex trafficking. Nothing in the preceding 
sentence shall be construed to preclude the provision to individuals of 
palliative care, treatment, or post-exposure pharmaceutical 
prophylaxis, and necessary pharmaceuticals and commodities, including 
test kits, condoms, and, when proven effective, microbicides. A 
recipient that is otherwise eligible to receive funds in connection 
with this document to prevent, treat, or monitor HIV/AIDS shall not be 
required to endorse or utilize a multisectoral approach to combating 
HIV/AIDS, or to endorse, utilize, or participate in a prevention method 
or treatment program to which the recipient has a religious or moral 
objection. Any information provided by recipients about the use of 
condoms as part of projects or activities that are funded in connection 
with this document shall be medically accurate and shall include the 
public health benefits and failure rates of such use.
    In addition, any foreign recipient must have a policy explicitly 
opposing, in its activities outside the United States, prostitution and 
sex trafficking, except that this requirement shall not apply to the 
Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health 
Organization, the International AIDS Vaccine Initiative or to any 
United Nations agency, if such entity is a recipient of U.S. government 
funds in connection with this document.
    The following definitions apply for purposes of this clause:
     Sex trafficking means the recruitment, harboring, 
transportation, provision, or obtaining of a person for the purpose of 
a commercial sex act. 22 U.S.C. 7102(9).
     A foreign recipient includes an entity that is not 
organized under the laws of any State of the United States, the 
District of Columbia or the Commonwealth of Puerto Rico. Restoration of 
the Mexico City Policy, 66 FR 17303, 17303 (March 28, 2001).
    All recipients must insert provisions implementing the applicable 
parts of this section, ``Prostitution and Related Activities,'' in all 
subagreements under this award. These provisions must be express terms 
and conditions of the subagreement, acknowledge that each certification 
to compliance with this section, ``Prostitution and Related 
Activities,'' are a prerequisite to receipt of U.S. government funds in 
connection with this document, and must acknowledge that any violation 
of the provisions shall be grounds for unilateral termination of the 
agreement prior to the end of its term. In addition, all recipients 
must ensure, through contract, certification, audit, and/or any other 
necessary means, all the applicable requirements in this section, 
``Prostitution and Related Activities,'' are met by any other entities 
receiving U.S. government funds from the recipient in connection with 
this document, including without limitation,

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the recipients' sub-grantees, sub-contractors, parents, subsidiaries, 
and affiliates. Recipients must agree that HHS may, at any reasonable 
time, inspect the documents and materials maintained or prepared by the 
recipient in the usual course of its operations that relate to the 
organization's compliance with this section, ``Prostitution and Related 
Activities.''
    All primary grantees receiving U.S. Government funds in connection 
with this document must certify compliance prior to actual receipt of 
such funds in a written statement referencing this document (e.g., 
``[Recipient's name] certifies compliance with the section, 
`Prostitution and Related Activities.' ``) addressed to the agency's 
grants officer. Such certifications are prerequisites to the payment of 
any U.S. Government funds in connection with this document.
    Recipients' compliance with this section, ``Prostitution and 
Related Activities,'' is an express term and condition of receiving 
U.S. government funds in connection with this document, and any 
violation of it shall be grounds for unilateral termination by HHS of 
the agreement with HHS in connection with this document prior to the 
end of its term. The recipient shall refund to HHS the entire amount 
furnished in connection with this document in the event it is 
determined by HHS that the recipient has not complied with this 
section, ``Prostitution and Related Activities.''
    Funds may be used for:
     RCT at the facilities targeted by the project including 
required training, test kit purchase, simple laboratory refurbishment, 
additional staffing, and other related expenses.
     Strengthening hospital and care provider ability to 
provide basic preventive care and palliative care for people living 
with HIV/AIDS (PHAs) through training, improved referral, strengthening 
delivery of key elements of preventive and palliative care packages and 
purchasing of commodities if necessary.
     Evaluation and management of the activities.
    Funding in the first year will be limited to activities at two 
facilities in different districts.
    Awards will not allow reimbursement of pre-award costs.
    Guidance for completing your budget can be found on the United 
States government Web site at the following address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm.

IV.6. Other Submission Requirements

    Application Submission Address: Submit the original and two hard 
copies of your application by mail or express delivery service to: 
Technical Information Management Section--PA 04229, CDC Procurement and 
Grants Office, 2920 Brandywine Road, Atlanta, GA 30341.
    Applications may not be submitted electronically at this time.

V. Application Review Information

V.1. Criteria

    You 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.
    Your application will be evaluated against the following criteria:
    1. Understanding the issues, principles and systems requirements 
involved in delivering RCT and basic care for PHAs in a district 
clinical context in Uganda (25 points).
    Does the applicant demonstrate an understanding of the ethical, 
clinical, social, managerial and other practical issues involved in 
delivering RCT and basic care effectively, sensitively and sustainably 
in the setting of Ugandan district health services and faith-based care 
providers?
    2. Ability to carry out the proposal (25 points).
    Does the applicant demonstrate the capability to achieve the 
purpose of this proposal?
    3. Work Plan (20 points).
    Does the applicant describe activities which are realistic, 
achievable, time-framed and appropriate to complete this program?
    4. Personnel (15 points).
    Are the personnel (including their qualifications, training, 
availability, and experience) adequate to carry out the proposed 
activities?
    5. Administrative and Accounting Plan (15 points).
    Is there a plan to account for, prepare reports, monitoring and 
audit expenditures under this agreement, manage the resources of the 
program and produce, collect and analyze performance data?
    6. Budget (not scored).
    Is the budget for conducting the activity itemized and well-
justified and consistent with stated activities and planned program 
activities?

V.2. Review and Selection Process

    Applications will be reviewed for completeness by the Procurement 
and Grants Office (PGO) staff and for responsiveness by NCHSTP/GAP. 
Incomplete applications and applications that are non-responsive to the 
eligibility criteria will not advance through the review process. 
Applicants will be notified that their application did not meet 
submission requirements.
    An objective review panel will evaluate complete and responsive 
applications according to the criteria listed in the ``V.1. Criteria'' 
section above.

V.3. Anticipated Announcement and Award Dates

    September 1, 2004.

VI. Award Administration Information

VI.1. Award Notices

    Successful applicants will receive a Notice of Grant Award (NGA) 
from the CDC Procurement and Grants Office. The NGA shall be the only 
binding, authorizing document between the recipient and CDC. The NGA 
will be signed by an authorized Grants Management Officer, and mailed 
to the recipient fiscal officer identified in the application.
    Unsuccessful applicants will receive notification of the results of 
the application review by mail.

VI.2. Administrative and National Policy Requirements

45 CFR Part 74 and Part 92
    For more information on the Code of Federal Regulations, see the 
National Archives and Records Administration at the following Internet 
address: http://www.access.gpo.gov/nara/cfr/cfr-table-search.html.
    The following additional requirements apply to this project:

 AR-10 Smoke-Free Workplace Requirements

    Additional information on these requirements can be found on the 
CDC Web site at the following Internet address: http://www.cdc.gov/od/pgo/funding/ARs.htm.

VI.3. Reporting Requirements

    You must provide CDC with an original, plus two hard copies of the 
following reports:
    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

[[Page 32578]]

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.
    f. Measures of effectiveness.
    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.
    4. Semi-annual progress reports, 30 days after the end of the 
budget period.
    These reports must be mailed to the Grants Management or Contract 
Specialist listed in the ``Agency Contacts'' section of this 
announcement.

VII. Agency Contacts

    For general questions about this announcement, contact: Technical 
Information Management Section, CDC Procurement and Grants Office, 2920 
Brandywine Road, Atlanta, GA 30341, Telephone: (770) 488-2700.
    For program technical assistance, contact: Jonathan Mermin, MD, 
MPH, Global AIDS Program, Uganda Country Team, National Center for HIV, 
STD and TB Prevention, Centers for Disease Control and Prevention P.O. 
Box 49, Entebbe, Uganda, Telephone: +256-41320776, e-mail: [email protected].
    For financial, grants management, or budget assistance, contact: 
Shirley Wynn, Contract Specialist, Procurement and Grants Office, 
Centers for Disease Control and Prevention, 2920 Brandywine Road, 
Atlanta, GA 30341-4146, Telephone: (770) 488-1515, e-mail address: 
[email protected].

    Dated: June 4, 2004.
William P. Nichols,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 04-13141 Filed 6-9-04; 8:45 am]
BILLING CODE 4163-18-P