[Federal Register Volume 69, Number 118 (Monday, June 21, 2004)]
[Notices]
[Pages 34365-34373]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-13894]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Request for Applications for the National Community Centers of 
Excellence in Women's Health (CCOE) Program

    Announcement Type: Competitive Cooperative Agreement--FY 2004 
Initial announcement.
    Funding Opportunity Number: Not applicable.
    Catalog of Federal Domestic Assistance: The Catalog of Federal 
Domestic Assistance number is 93.290.
    Dates: To receive consideration applications must be received by 
the Office of Public Health and Science (OPHS) Grants Management Office 
no later than July 20, 2004, 5 p.m. eastern standard time.
    Summary: The National Community Centers of Excellence in Women's 
Health (CCOE) program provides funding to community-based organizations 
to enhance their women's health program through the integration of the 
following six components: (1) Leadership development for women as 
health care consumers and providers, (2) training for lay, allied 
health, and professional health care providers that includes a rural 
health focus, (3) public education and outreach with special emphasis 
on outreach to Native American women and/or rural/frontier communities, 
(4) comprehensive health service delivery that includes gender and age-
appropriate preventive services and allied health professionals as 
members of the comprehensive care team, (5) community-based research 
that uses the findings to improve the management and delivery of 
comprehensive, integrated care to all women, and (6) replication of the 
model in another community to improve health outcomes for underserved 
women. The CCOE program is not for the development of new programs or 
to fund direct service, but rather to integrate, coordinate, and 
strengthen linkages between activities/programs that are already 
underway in the community to reduce fragmentation in women's health 
services.
    Under this announcement the Office on Women's Health (OWH) 
anticipates making, through the cooperative agreement grant mechanism, 
2 to 4 new 5-year awards by September 30, 2004. Approximately $450,000 
is available to make awards of up to $150,000 total cost (direct and 
indirect) for a 12-month budget period and $750,000 for the 5-year 
project period. Cost sharing and matching funds is not a requirement of 
this grant. The actual number of awards made will depend upon the 
quality of the applications received and the amount of funds available 
for the CCOE program. The government is not obligated to make any 
awards as a result of this announcement.
    Eligible applicants are public or private nonprofit community-based 
hospitals, community health centers, and other community-based 
organizations serving underserved women. Community health centers 
funded under section 330 of the Public Health Service Act and faith-
based organizations are also encouraged to apply. To increase the 
likelihood of funding a CCOE in Region VIII, in rural/frontier 
communities and in communities of Native American women, the OWH will 
award bonus points to applicants meeting these criteria. Application 
kits may be obtained from Ms. Karen Campbell, Director, OPHS Office of 
Grants Management, 1101 Wootton Parkway, Suite 550, Rockville, MD 
20852, telephone: (301) 594-0758, e-mail: [email protected].

I. Funding Opportunity Description

    Authority: This program is authorized by 42 U.S.C. 300u-2(a)(1), 
300u-6(e). The primary purpose of the National Community Center of 
Excellence in Women's Health (CCOE) program is the

[[Page 34366]]

creation of ``one-stop shopping'' or ``centers without walls'' models 
of women's health care that is a convenient, user-friendly, 
interdisciplinary, comprehensive, and integrated care delivery system 
that enables women of all ages and racial/ethnic groups to receive 
quality services in a women-friendly, supportive environment. The 
Department of Health and Human Services (DHHS) Office on Women's Health 
(OWH) believes that this novel approach to women's health will help to 
eliminate many of the access barriers and continuity of care issues 
women encounter when seeking services as well as to reduce 
fragmentation of care.
    The OWH hopes to fulfill this purpose by providing funds to 
community-based organizations to enhance their women's health program 
through the integration of the following six components: (1) Leadership 
development for women as health care consumers and providers, (2) 
training for lay, allied health, and professional health care providers 
that includes a rural health focus, (3) public education and outreach 
with special emphasis on outreach to Native American women and/or 
rural/frontier communities, (4) comprehensive health service delivery 
that includes gender and age-appropriate preventive services and allied 
health professionals as members of the comprehensive care team, (5) 
community-based research that uses the findings to improve the 
management and delivery of comprehensive, integrated care to all women, 
and (6) replication of the model in another community to improve health 
outcomes for underserved women. The CCOE program is not for the 
development of new programs or to fund direct service, but rather to 
integrate, coordinate, and strengthen linkages between activities/
programs that are already underway in the community to reduce 
fragmentation in women's health services.
    The proposed CCOE program must address women's health from a 
gender-based, women-centered, women-friendly, women-relevant, holistic, 
multi-disciplinary, cultural and community-based perspective. 
Information and services provided must be culturally and linguistically 
appropriate for the individuals for whom the information and services 
are intended. Women's health issues are defined in the context of 
women's lives, including their multiple social roles and the importance 
of relationships with other people to their lives. This definition of 
women's health encompasses mental, dental, and physical health and 
spans the life course.
    The goals of the CCOE program are to:
    1. Increase the number of health professionals, including allied 
health professionals, trained to work with underserved, Native 
American, and rural/frontier communities and to increase their 
leadership and advocacy skills.
    1a. Increase the number of young women, especially Native 
Americans, Blacks, and Hispanics, who pursue health careers and 
increase the leadership skills and opportunities for women in the 
community.
    2. Eliminate health disparities for women who are underserved due 
to age, gender, race/ethnicity, education, income, disability, or 
living in rural/frontier localities.
    3. Reduce the fragmentation of women's health services and access 
barriers by using a framework that coordinates and integrates 
comprehensive health services. Comprehensive health services include 
gender and age-appropriate preventive services and allied health 
professionals on the service delivery team.
    4. Increase the women's health knowledge base by involving the 
community in identifying and conducting research related to and 
responsive to the health needs and issues of concern to underserved 
women in the target community.
    5. Empower underserved women as health care consumers and decision-
makers.
    A CCOE program must: (1) Develop and/or strengthen a framework to 
bring together a comprehensive array of services for women with an 
emphasis on service delivery to Native American women and/or rural/
frontier communities; (2) develop promising strategies to train a cadre 
of health care providers that include allied health professionals and 
community health workers who are capable of addressing issues at the 
community level that impact underserved women's health needs; (3) 
promote leadership/career development for women in the health 
professions, including allied health professions and community health 
workers, and women/girls in the community; (4) enhance public education 
and outreach activities in women's health with an emphasis on gender-
specific and age-appropriate prevention and/or reduction of illness or 
injuries that appear controllable through increased knowledge that 
leads to a modification of behavior; (5) participate in a national 
evaluation of the CCOE program; (6) conduct community-based research in 
women's health that uses the results to improve the services and care 
provided to women in the community; (7) evaluate their program; and (8) 
demonstrate an ability to foster the transfer of lessons learned to 
other communities interested in improvements in women's health. A CCOE 
program may develop outreach and education materials, training programs 
that include a focus on rural/frontier health and the effective use of 
allied health professionals in care delivery, and leadership 
development activities/materials. Award recipients must also, with 
input from community representatives, put into place and track a set of 
measurable objectives for improving health outcomes and decreasing 
health disparities for underserved women in the community. In addition, 
the CCOE program must contribute to the development of a comprehensive 
national CCOE ``how-to'' manual by submitting a site-specific manual 
that is updated annually and describes the steps taken to implement 
each component of the CCOE program, a discussion of the effectiveness 
of the implementation strategy(ies) and how measured, and the impact of 
the program on the targeted community/population. A comprehensive 
outline for the manual has been prepared and will be given to 
successful applicants at the orientation meeting. A draft manual will 
be developed in FY 2004, using the information provided, and made 
available to other community-based organizations interested in 
establishing a CCOE program. The OWH plans to publish a final 
comprehensive ``how-to'' manual near the end of 2005.
    At a minimum, each CCOE clinical care center (ccc) must be a 
physically-identifiable space, within the CCOE facility(s), for the 
delivery of comprehensive health care that includes gender and age-
appropriate preventive services for women. The CCOE clinical care 
center must have permanent signage and be devoted to women-friendly, 
women-centered, women-relevant care delivered from a multidisciplinary, 
holistic, and culturally and linguistically appropriate perspective. 
The CCOE clinical care center must also have a clinical intake form, 
referral and tracking system, and procedures for identifying and 
counting the women served by the CCOE by specialty area and for 
tracking the cost of services provided to women who receive 
interdisciplinary care through the CCOE program. Sites must be able to 
differentiate the care provided to women counted as CCOE patients 
compared to non-CCOE patients.

[[Page 34367]]

II. Award Information

    The CCOE program will be supported through the cooperative 
agreement mechanism. Using this mechanism, the OWH anticipates making 2 
to 4 new 5-year awards in FY 2004. The anticipated start date for new 
awards is September 30, 2004, and the anticipated period of performance 
is September 30, 2004, through September 29, 2009. Approximately 
$450,000 is available to make awards of up to $150,000 total cost 
(direct and indirect) for a 12-month budget period and $750,000 for the 
5-year project period. However, the actual number of awards made will 
depend upon the quality of the applications received and the amount of 
funds available for the CCOE program. Noncompeting continuation awards 
of up to $150,000 (total cost) per year will be made subject to 
satisfactory performance and availability of funds.
    Under previous program announcements, the OWH funded three new 
programs in FY 2000, four new programs in FY 2001, and five new 
programs in FY 2003. A total of 12 programs have been funded.
    The CCOE program is a collaborative effort between the OWH, the 
Office of Minority and Special Populations in the Bureau of Primary 
Health Care of the Health Resources and Services Administration, and 
the Office of Minority Health within the Office of Public Health and 
Science, DHHS. These offices will provide the technical assistance and 
oversight necessary for the implementation, conduct, and assessment of 
program activities. The applicant shall:

    1. Implement the CCOE model described in the application.
    2. Develop implementation plans and replicate the CCOE model in 
another community.
    3. Conduct an evaluation of their CCOE program.
    4. Participate in the annual meetings of the CCOE Center 
Directors.
    5. Participate in the development of a comprehensive national 
CCOE ``How to'' manual.
    6. Participate in a national evaluation of the CCOE program 
following the guidance provided by the OWH contractor.
    7. Design and implement a CCOE Web site within six months of 
receipt of the award that comply with Federal Web site development 
guidance.
    8. Display permanent signage designating the facility as a 
National Community Center of Excellence in Women's Health.
    9. Participate in special meetings and projects/funding 
opportunities identified and/or offerers by the OWH.
    10. Adhere to all program requirements specified in the CCOE 
Federal Register notice, the Memorandum of Understanding, and the 
Notice of Grant Award.
    11. Submit required progress, annual, and financial reports by 
the due dates stated in this announcement and the Notice of Grant 
Award.

    The Federal government will:

    1. Participate in at least two annual meetings with the CCOE 
Center Directors and Program Coordinators.
    2. Participate in the development of a comprehensive national 
CCOE ``How-to'' manual.
    3. Review and approve draft ``How to'' manuals.
    4. Participate in a national evaluation of the CCOE programs 
using Guidance /measurements provided by the OWH contractor.
    5. Review and concur with requested project modifications.
    6. Review the design of CCOE Web sites.
    7. Site visit CCOE facilities.
    8. Review all quarterly, annual, and final progress reports.
    9. Conduct an orientation meeting for the new CCOEs within the 
first month of funding.
    10. Facilitate review and clearance of all Center publications 
to insure adherence to DHHS policies.
    11. Revise implementation plan for and approve the replication 
sites.

    The DHHS is committed to achieving the health promotion and disease 
prevention objectives of Healthy People 2010 and the HealthyUS 
Initiative. Emphasis will be placed on aligning CCOE activities and 
programs with the DHHS Secretary's four priority areas--heart disease, 
cancer, diabetes, and HIV/AIDS--and with the Healthy People 2010: Goal 
2--eliminating health disparities due to age, gender, race/ethnicity, 
education, income, disability, or living in rural localities. More 
information on the Healthy People 2010 objectives may be found on the 
Healthy People 2010 Web site: http://www.health.gov/healthypeople. 
Another reference is the Healthy People 2000 Review--1998-99. One free 
copy may be obtained from the National Center for Health Statistics 
(NCHS), 6525 Belcrest Road, Room 1064, Hyattsville, MD 20782 or 
telephone (301) 458-4636 (DHHS Publication No. (PHS) 99-1256). This 
document may also be downloaded from the NCHS Web site: http://www.cdc.gov/nchs. Also, Steps to a HealthierUS is a bold new initiative 
from the Department that advances the goal of helping Americans live 
longer, better, and healthier lives.
    To help implement the HealthierUS initiative, the Department 
launched the Steps to a HealthierUS program. It lays out DHHS 
priorities and programs for Steps to a HealthierUS, focusing attention 
on the importance of prevention and promising approaches for promoting 
healthy environments.

III. Eligibility Information

    Eligible Applicants. The CCOE applicant must be a public or private 
nonprofit community-based hospital, community health center, or 
community-based organization serving underserved women. Programs that 
will be implemented in medically underserved areas, enterprise 
communities, and empowerment zones as well as community health centers 
funded under section 330 of the Public Health Service Act and faith-
based organizations are encouraged to apply. Native American tribal 
organizations meeting these eligibility criteria are also encouraged to 
apply.
    All applicants receiving section 330 funding must identify 
themselves as recipients of these funds in the Background section of 
the application and by checking the appropriate response on the OWH 
Project Profile form. Community entities/organizations, including 
faith-based organizations, that have alliances, partnerships, networks 
with, or other affiliations with an academic health center are also 
eligible to apply for a CCOE grant as long as the community entity/
organization has a leading management role in the activity and 
maintains control of all funding. Academic health centers and State, 
county, and local health departments are not eligible for funding under 
this announcement.
    Cost Sharing or Matching Funds. Cost sharing, matching funds, and 
cost participation is not a requirement of this grant.
    Other. Preference will be given to:
    1. Applicants located in DHHS Region VIII (Colorado, Montana, North 
Dakota, South Dakota, Utah, and Wyoming),
    2. Organizations located in rural and/or frontier communities, and
    3. Organizations serving significant numbers of Native American 
women.
    To increase the likelihood of funding a CCOE in Region VIII, in 
rural/frontier communities, and in communities that serve a significant 
number of Native American women, the OWH will award bonus points to 
applicants meeting these criteria. The bonus points available are shown 
below:

Rural/Frontier site or population--10 points
DHHS Region VIII applicants--5 points
Native American population--5 points

    To be considered eligible for review, applications must be received 
by the Office of Public Health and Science (OPHS), Office of Grants 
Management by 5 p.m. on July 20, 2004. Applications will be considered 
as meeting the deadline if they are received on or before the deadline 
date. The

[[Page 34368]]

application due date requirement in this announcement supercedes the 
instructions in the PHS 5161-1. Applications submitted by facsimile 
transmission (FAX) or any other electronic format are ineligible for 
review and will not be accepted. Applications that do not meet the 
deadline will be considered ineligible and will be returned to the 
applicant unread.
    Applicants are required to submit an original ink-signed and dated 
application and 2 photocopies. All pages must be numbered clearly and 
sequentially beginning with the Project Profile. The application must 
be typed double-spaced on one side of plain 8 \1/2\ x 
11 white paper, using at least a 12 point font, and contain 
1'' margins all around. Applications not adhering to these guidelines 
may not be reviewed.
    Applications will be screened upon receipt. Those that are judged 
to be incomplete or arrive after the deadline will be returned without 
review or comment. Applications that exceed the requested amount of 
$150,000 for a twelve-month budget period and $750,000 for the five-
year project period may also be returned without review or comment.

IV. Application and Submission Information

    1. Address to Request Application Package: Application kits may be 
requested by calling (301) 594-0758 or writing to Ms. Karen Campbell, 
Director, Office of Public Health and Science (OPHS) Office of Grants 
Management, 1101 Wootton Parkway, Suite 550, Rockville, MD 20852. 
Applications must be prepared using Form PHS 5161-1 (revised July 
2000). This form is available in Adobe Acrobat format at the following 
Web site: http://www.cdc.gov/od/pgo/forminfo.htm.
    2. Content and Format of Application and Submission: At a minimum, 
each application for a cooperative agreement grant funded under this 
CCOE announcement must:
     Present a plan to integrate all six components of the CCOE 
program by the end of the first year of funding, although only four 
components have to be in place at the time the application is 
submitted. The four established components (public education and 
outreach, leadership development, comprehensive health services, and 
one selected by the applicant) must be clearly identified in the 
proposal. Applicants are encouraged to be creative in suggesting ways 
to increase integration among the CCOE components.
     Develop a CCOE advisory board or ensure that their already 
established advisory board is included in the decision-making process 
for CCOE program development, identification of community-based 
research questions, and formulation of CCOE policies. If the role of 
the established advisory board is expanded to include the CCOE program, 
then the applicants should also ensure that the advisory board includes 
representative(s) from the CCOE program and its community partner 
organizations. CCOE advisory board members and their organizational 
affiliation must be clearly identified in the proposal.
     Be a sustainable organization with an established network 
of partners capable of providing coordinated and integrated women's 
health services in the targeted community. The network of partner 
organizations must have the capability to coordinate and provide 
comprehensive, seamless health services for women and empower them with 
community-based women's health research information that addresses 
issues of particular concern to the women, teaching/training 
opportunities in women's health, leadership opportunities in health for 
community women, and community outreach/education activities in women's 
health to improve the health status of women in the community. The 
partners and their roles and responsibilities to the CCOE must be 
clearly identified in the application. The applicant will need to 
define the components of comprehensive care, demonstrate that they are 
culturally, linguistically, and gender and age appropriate, and show 
that they have a clear and sustainable framework for providing those 
services.
     Have an established clinical care center/facility, an 
operating public education/outreach program, and a leadership 
development plan. A time line and plans for phasing in the remaining 
CCOE components, except replication, by the end of Year 1 must be 
described in detail in the application.
     Demonstrate the ways in which the organization and the 
care that are coordinated through its partners are gender and age 
appropriate, women-focused, women-friendly, women-relevant, and 
sensitive to the importance of patient/provider communication/
relationships for medically underserved women of all ages. The care 
that is coordinated through this organization must be focused on health 
promotion, disease prevention, and treatment and use allied health 
professionals in the delivery of care.
     Detail/specify the roles and resources/services that each 
partner organization bring to the program, the duration and terms of 
agreement as confirmed by a signed agreement between the applicant 
organization and each partner, and describe how the partner 
organizations will operate within the CCOE structure. The partnership 
agreement(s) must name the individual who will work with the CCOE 
program, describe their function, and state their qualifications. The 
documents, specific to each organization (form letters are not 
acceptable), must be signed by individuals with the authority to 
represent and bind the organization (e.g., president, chief executive 
officer, executive director, or other similarly situated individual) 
and submitted as part of the grant application.
     Describe in detail plans for the local evaluation of the 
CCOE program and when and how information obtained from the evaluation 
will be used to enhance the CCOE program. The applicant must also 
indicate their willingness to participate in a national evaluation of 
the CCOE program to be conducted under the leadership of the OWH 
contractor.
     Describe in detail the women's health research agenda, the 
planned community-based research and the research methodology/
procedure. Applicants may: (a) Propose original patient-oriented 
research; (b) enter into a formal agreement with institutions 
conducting population-based research to facilitate women's entry into 
clinical trial(s)/patient-oriented research; (c) participate in the 
national evaluation of the CCOE program (required of all awardees); (d) 
link with organizations conducting community-based research; and/or (e) 
propose other original/creative research projects. To satisfy the 
community-based research component of the CCOE program, all applicants 
must have a women's health research agenda and undertake at least two 
of the research activities listed above. However, if a CCOE proposes to 
conduct original research and participate in the national evaluation of 
the CCOE program, these two activities will satisfy the community-based 
research component.
    3. Format and Limitations of Application: Applicants are required 
to submit an original ink-signed and dated application and 2 
photocopies. All pages must be numbered clearly and sequentially 
beginning with the Project Profile. The application must be typed 
double-spaced on one side of plain 8 \1/2\ x 11 
white paper, using at least a 12

[[Page 34369]]

point font, and contain 1 margins all around.
    The Project Summary and Project Narrative must not exceed a total 
of 25 double-spaced pages, excluding the appendices. The original and 
each copy must be stapled and/or otherwise securely bound. The 
application should be organized in accordance with the format presented 
in the Program Guidelines. An outline for the minimum information to be 
included in the ``Project Narrative'' section is presented below. The 
content requirements for the Project Narrative portion of the 
application are divided into five sections and are described below 
within each Factor. Applicants must pay particular attention to 
structuring the narrative to respond clearly and fully to each review 
Factor and associated criteria. Applications not adhering to these 
guidelines may not be reviewed.

I. Background
    A. Local CCOE goals and purpose(s)
    B. Section 330 funding
    C. Local CCOE program objectives
    1. Tied to program goal(s)
    2. Measurable with time frame
    3. Elements identified in Factor 5: Objectives
    D. CCOE organization charts that include partners and a 
discussion of the resources being contributed by the CCOE, partners, 
personnel and their expertise and how their involvement will help 
achieve the CCOE program goals
II. Implementation Plan (Approach to the establishment of the CCOE 
program)
    A. Four components in place, integration plans with a timetable 
for phasing in the other two components
    B. Partnerships and referral system/follow up
    C. Community-based research
    D. Plans for sustaining the CCOE
    E. National CCOE ``how-to'' manual
    F. Elements identified in Factor 1: Implementation Plan
III. Management Plan
    A. Key project staff, their resumes, and a staffing chart for 
budgeted staff
    B. To-be-hired staff and their qualifications
    C. Staff responsibilities
    D. Management experience of the lead agency and partners as 
related to their role in the CCOE program
    E. Succession planning and cross-training of responsibilities
    F. CCOE Advisory board
    G. Elements identified in Factor 2: Management Plan
IV. Local CCOE Evaluation Plan
    A. Purpose
    B. Design/methodology
    C. Use of results to enhance programs
    D. Elements identified in Factor 3: Evaluation Plan
V. Technical Assistance/Replication Strategy
    A. Identification of replication site
    B. Reason for selection of replication site
    C. Time line for phasing in and integrating components
    D. Technical Assistance plans/strategies
    E. Elements identified in Factor 4: Technical Assistance
Appendices
    A. Memorandums of Agreement/Understanding/Partnership Letters
    B. Required Forms (Assurance of Compliance Form, etc.)
    C. Key Staff Resumes
    D. Charts/Tables (Partners, advisory board, services, population 
demographics, components, etc.)
    E. Other attachments

    Use of Funds: A majority of the funds from the CCOE award must be 
used to support staff and efforts aimed at coordinating and integrating 
the six components of the CCOE program. The Center Director, or the 
person responsible for the day-to-day management of the CCOE program, 
must devote at least a 75 percent level of effort to the program. Funds 
may also be used to transfer the lessons learned/successful strategies 
from the CCOE program (technical assistance) through activities such as 
showcasing the Center at meetings and workshops; providing direct 
technical assistance to other communities; and providing technical 
assistance to allied health and health professionals, directly or 
through their professional organizations, interested in working with 
underserved women in the community. These may include either process-
based lessons (i.e., How to bring multiple community partners together) 
or outcomes-based lessons (i.e., How to increase diabetes screening and 
control through improved outreach, education, and treatment).
    4. Replication of Model: The CCOE is also required to replicate its 
model in an organization that is not an entity of the parent grant 
organization. The replication site should be identified at the time the 
application is submitted to the OWH. A Memorandum of Understanding 
(MOU), signed by an individual authorized to commit the organization to 
serve as a replication site, with a timeline for the complete 
replication of the CCOE model, should also be included in the 
application. As an alternative, a letter of commitment from 1-2 
organizations agreeing to serve as a replication site, if the final 
CCOE model is compatible with their organization's mission and 
infrastructure, is also an acceptable means of satisfying the 
replication requirement.
    Activities to replicate the model must be underway in Year 2 of the 
grant and completed by the end of Year 3. The entire integrated CCOE 
model--all components except technical assistance and replication--must 
be in place at the replication site by the end of Year 3. One approach 
to the replication of the CCOE model may be to start the process with 
the most developed component and phase in the other components. Another 
approach may be to begin with a component that will help address an 
identified need of the replication site. The OWH encourages the 
development of a replication strategy that will be most effective based 
on the needs and resources of the CCOE and the replication site.
    The OWH also encourages the selection of a community-based 
organization that has an on-going or prior relationship with the CCOE 
to facilitate the replication of the model and recommends that at least 
one representative from the CCOE participate in the planning meetings 
of the replication site and vice-versa. However, the selection of new 
community entities as replication sites is acceptable, if the applicant 
believes the site has the infrastructure and base components necessary 
to accommodate the CCOE model.
    To successfully implement the CCOE model, the replication site must 
have, at a minimum, a stable infrastructure and the commitment of the 
leadership. Below are additional characteristics/criteria of an 
eligible replication site:
    (a) Must be a community entity.
    (b) Must provide comprehensive interdisciplinary primary care and 
has already demonstrated some evidence of commitment to women-focused, 
women-friendly care.
    (c) Must have several CCOE components in place or at least there 
must be the ability to implement all components.
    (d) Must not be an academic health center/academic institution.
    (e) Must be financially viable with a strong funding base.
    Funds may be used for personnel, consultants, supplies (including 
screening, education, and outreach supplies), and grant related travel. 
Funds may not be used for construction, building alterations, 
equipment, medical treatment, or renovations. All budget requests must 
be justified fully in terms of the proposed CCOE goals and objectives 
and include an itemized computational explanation/breakout of how costs 
were determined.
    5. Meetings: The CCOE Center Directors will meet twice a year. The 
first meeting will be held in the Washington metropolitan area and the 
second meeting may be held on-site at one of the CCOEs. The CCOE's 
budget should include a request for funds to pay for the travel, 
lodging, and meals for the two Center Directors' meetings. The first 
meeting is usually held between mid-November and mid-December and

[[Page 34370]]

the second Center Directors' meeting is usually held in May.
    Center Directors are encouraged to bring their Program Coordinators 
to these meetings and should include their travel cost in the CCOE 
budget.
    In the first year of the award, the new CCOE Center Directors and 
Program Coordinators are required to attend an orientation meeting that 
will be held in the Washington metropolitan area on October 28, 2004. 
The CCOE's budget should also include a request for funds for 2 
participants (the CCOE Center Director and Program Coordinator) to 
attend this meeting.
    6. Submission Date and Time: To be considered for review, 
applications must be received by the Office of Public Health and 
Science (OPHS), Office of Grants Management by 5 p.m. Eastern Standard 
Time on July 20, 2004. Applications will be considered as meeting the 
deadline if they are: (1) Received on or before the deadline date or 
(2) postmarked on or before the deadline date and received in time for 
orderly processing. The application due date requirement in this 
announcement supercedes the instructions in the PHS 5161-1. 
Applications submitted by facsimile transmission (FAX) or any other 
electronic format will not be accepted. Applications not received by 
the deadline will be considered late and ineligible for consideration. 
They will be returned to the applicant unread.
    Applications will be screened upon receipt. Those that are judged 
to be incomplete or arrive after the deadline will be returned without 
review or comment. Applications that exceed the requested amount of 
$150,000 for a twelve-month budget period and $750,000 for the five-
year project period may also be returned without review or comment. 
Applicants that are judged to be in compliance will be notified via the 
PHS-3038-1 Application Receipt Record included in the grant application 
kit. Accepted applications will be reviewed for technical merit in 
accordance with DHHS policies. Applications will be evaluated by a 
technical review panel composed of experts in the fields of program 
management, community service delivery, community outreach, health 
education, community-based research, and community leadership 
development and evaluation. Consideration for award will be given to 
applicants that best demonstrate progress and/or plausible strategies 
for eliminating health disparities through the integration of training, 
leadership/career development, public education and outreach, 
comprehensive services that include gender and age-appropriate 
preventive services, community-based research, technical assistance to 
other communities and replication of the model. Applicants are advised 
to pay close attention to the specific program guidelines and general 
instructions in the application kit that may be obtained from Ms. Karen 
Campbell, Director, Office of Public Health and Science Office of 
Grants Management, 1101 Wootton Parkway, Suite 550, Rockville, MD 20852 
and to the definitions provided in this notice.
    Questions regarding programmatic information and/or requests for 
technical assistance in the preparation of the grant application should 
be directed in writing to Ms. Barbara James, CCOE Program Director, 
Office on Women's Health, Division of Program Management, Parklawn 
Building, Room 16A-55, 5600 Fishers Lane, Rockville, MD 20857, e-mail: 
[email protected]. Technical assistance on budget and business 
aspects of the application may be obtained from Ms. Karen Campbell, 
OPHS Grants Management Office, 1101 Wootton Parkway, Suite 550, 
Rockville, MD 20852, telephone: (301) 594-0758.
    Applications should be submitted to: Ms. Karen Campbell, Director, 
Office of Public Health and Science (OPHS) Office of Grants Management, 
1101 Wootton Parkway, Suite 550, Rockville, MD 20852.
    7. Intergovernmental Review: This program is subject to the Public 
Health Systems Reporting Requirements. Under these requirements, a 
community-based non-governmental applicant must prepare and submit a 
Public Health System Impact Statement (PHSIS). Applicants shall submit 
a copy of the application face page (SF-424) and a one page summary of 
the project, called the Public Health System Impact Statement. The 
PHSIS is intended to provide information to State and local health 
officials to keep them apprized on proposed health services grant 
applications submitted by community-based, non-governmental 
organizations within their jurisdictions.
    This program is also subject to the requirements of Executive Order 
12372 that allows States the option of setting up a system for 
reviewing applications from within their States for assistance under 
certain Federal programs. The application kit to be made available 
under this notice will contain a listing of States that have chosen to 
set up a review system and will include a State Single Point of Contact 
(SPOC) in the State for review. Applicants (other than federally 
recognized Indian tribes) should contact their SPOCs as early as 
possible to alert them to the prospective applications and receive any 
necessary instructions on the State process. For proposed projects 
serving more than one State, the applicant is advised to contact the 
SPOC in each affected State. A complete list of SPOCs may be found at 
the following Web site: http://www.whitehouse.gov/omb/grants/spoc.html. 
The due date for State process recommendations is 60 days after the 
application deadline. The OWH does not guarantee that it will 
accommodate or explain its responses to State process recommendations 
received after that date. (See ``Intergovernmental Review of Federal 
Programs,'' Executive Order 12372, and 45 CFR part 100 for a 
description of the review process and requirements.)
    Community-based, non-governmental applicants are required to 
submit, no later than the Federal due date for receipt of the 
application, the following information to the head of the appropriate 
state and local health agencies in the area(s) to be impacted: (a) a 
copy of the face page of the application (SF 424), (b) a summary of the 
project (PHSIS), not to exceed one page, which provides: (1) A 
description of the population to be served, (2) a summary of the 
services to be provided, and (3) a description of the coordination 
planned with the appropriate state or local health agencies. Copies of 
the letters forwarding the PHSIS to these authorities must be contained 
in the application materials submitted to the OWH.
    8. Funding Restrictions: Funds may not be used for construction, 
building alterations, equipment purchase, medical treatment, 
renovations or to purchase food.
    9. Other Submission Requirements: Beginning October 1, 2003, all 
applicants are required to obtain a Data Universal Numbering System 
(DUNS) number as preparation for doing business electronically with the 
Federal Government. The DUNS number must be obtained prior to applying 
for OWH funds. The DUNS number is a nine-character identification code 
provided by the commercial company Dun & Bradstreet, and serves as a 
unique identifier of business entities. There is no charge for 
requesting a DUNS number, and you may register and obtain a DUNS number 
by either of the following methods: Telephone: 1-866-705-5711; Web 
site: https://www.dnb.com/product/eupdate/requestOptions.html.
    Be sure to click on the link that reads, ``DUNS Number Only'' at 
the right hand, bottom corner of the screen to access the free 
registration page. Please note that registration via the Web site

[[Page 34371]]

may take up to 30 business days to complete.

V. Application Review Information

    Review Criteria: The technical review of applications will consider 
the following factors:

Factor 1: Implementation Plan--30 Points

    This section must discuss:
    1. Appropriateness of the existing community resources and linkages 
established to deliver coordinated, comprehensive women's services to 
meet the requirements of the CCOE program. Describe allied health 
professionals that will be affiliated with the program and their role 
in service delivery.
    2. Appropriateness of proposed approach, component integration, and 
specific activities described to address each element of the National 
Community Centers of Excellence in Women's Health program including: 
(a) Training for professional, allied health, and lay health care 
workers serving underserved women and rural/frontier communities, (b) 
leadership/career development for women providers, and Native American, 
Black, and Hispanic women/girls in the community, (c) outreach and 
education, (d) comprehensive women's health services that include 
gender and age-appropriate preventive services, (e) community-based 
research that involves the community in substantive roles/ways, and (f) 
replication of the CCOE model. Although only four components of the 
CCOE (comprehensive health services, public education and outreach with 
an emphasis on outreach to Native American women, leadership 
development, and one selected by the applicant) have to be in place/
operational at the time the application is submitted, the applicant 
must discuss/describe the resources available to support each 
component, time lines and plans for phasing in the remaining 
components, and the relationship of each integrated component to the 
overall goals and objectives of the CCOE program.
    3. Soundness of evaluation objectives for measuring program 
effectiveness and changes in health outcomes.
    4. Willingness to participate in the national CCOE evaluation.
    5. Willingness to contribute to the development of a comprehensive 
national CCOE ``how-to'' manual.

Factor 2: Management Plan--25 Points

    Applicant organization's capability to manage the project as 
determined by the qualifications of the proposed staff or requirements 
for ``to be hired'' staff; proposed staff level of effort; management 
experience of the lead agency; and the experience, resources and role 
of each partner organization as it relates to the needs and programs/
activities of the CCOE program, diversity of the CCOE staff as it 
relates to and reflects the community and populations served, 
integration of allied health professionals into the CCOE program, and 
integration of the advisory board into the CCOE activities. Detailed 
position descriptions, resumes of key staff, and a staffing chart 
should be included in the appendix. The management plan should also 
describe succession planning for key personnel and cross training of 
responsibilities. Thoughtful succession planning and cross training of 
responsibilities should contribute to the sustainability of the program 
and provide promotion potential.

Factor 3: Evaluation Plan--15 Points

    A clear statement of program goal(s) and thoroughness, feasibility 
and appropriateness of the local CCOE evaluation design, data 
collection plan, analysis of results, and procedures to determine if 
the program goals are met. A clear statement of willingness to 
participate actively in the national CCOE evaluation.

Factor 4: Technical Assistance/Replication of the Model--10 Points

    This section should include plans for the replication of the CCOE 
model in a similar population and/or community. The plan must include 
justification for the community selected and a detailed discussion of 
how the applicant will replicate their model in the community. 
Appropriate MOUs or Letters of Intent should support assertions made in 
this section. Technical assistance activities to be undertaken by the 
CCOE, target audience, and purpose of the activity should be described.

Factor 5: Objectives--10 Points

    Merit of the objectives outlined by the applicant to address the 
CCOE program discussed in the program goals section in a way relevant 
to the targeted community needs and available resources. Objectives 
must be measurable and attainable within a stated time frame.

Factor 6: Background--10 Points

    Adequacy of demonstrated knowledge of systems of health care for 
underserved women at the local level; demonstrated need within the 
proposed local community and target population of underserved women; 
demonstrated support and established linkages in place to operate a 
fully functional CCOE program; demonstrated access to medically 
underserved women, including Native American women; and documented past 
efforts/activities outcome with underserved women. Clear description of 
the CCOE target population including total population, percent women, 
race/ethnicity data, and age distribution. Suggested tables to be used 
to report these data are included in the Program Guidance/Application 
Kit.
    Review and Selection Process: Accepted applications will be 
reviewed for technical merit in accordance with DHHS policies. 
Applications will be evaluated by a technical review panel composed of 
experts in the fields of program management, community service 
delivery, community outreach, health education, community-based 
research, and community leadership development and evaluation. 
Consideration for award will be given to applicants that best 
demonstrate progress and/or plausible strategies for eliminating health 
disparities through the integration of training, leadership/career 
development, public education and outreach, comprehensive services that 
include gender and age-appropriate preventive services, community-based 
research, technical assistance to other communities and replication of 
the model.
    Funding decisions will be made by the OWH, and will take into 
consideration the recommendations and ratings of the review panel, 
program needs, geographic location, stated preferences, and the 
recommendations of DHHS Regional Women's Health Coordinators (RWHC). A 
pre-award site visit, conducted by DHHS RWHCs, will be scheduled prior 
to the award of a grant with all applicants with scores in the funding 
range. The purpose of the pre-award site visit will be to assess the 
applicant's readiness to implement a CCOE program. The OWH plans to 
conduct the pre-award site visits during the week of August 16, 2004.
    To increase the likelihood of funding a CCOE in Region VIII, in 
rural/frontier communities, and in communities that serve a significant 
number of Native American women, the OWH will award bonus points to 
applicants meeting these criteria. The bonus points available are shown 
below:

Rural/Frontier site or population--10 points
DHHS Region VIII applicants--5 points
Native American population--5 points

VI. Award Administration Information

    1. Award Notices: Within two weeks of the review of all 
applications, all

[[Page 34372]]

applicants will receive a letter stating whether they are likely to be 
or have not been approved for funding. For those likely to be funded, 
the letter is not an authorization to begin performance of grant 
activities. Applicants selected for funding support will receive a 
Notice of Grant Award signed by the grants officer. This is the 
authorizing document and it will be sent electronically and followed up 
with a mailed copy. Pre-award costs are not supported.
    2. Administrative and National Policy Requirements: (1) Requests 
that require prior approval from the awarding office (see Chapter 8, 
PHS Grants Policy Statement) must be submitted in writing to the GMO. 
Only responses signed by the GMO are to be considered valid. Grantees 
who take action on the basis of responses from other officials do so at 
their own risk. Such responses will not be considered binding by or 
upon the OWH. (2) Responses to reporting requirements, conditions, and 
requests for post-award amendments must be mailed to the attention and 
address of the Grants Management Specialist indicated below in 
``Contacts.'' All correspondence requires the signature of an 
authorized business official and/or the project director. Failure to 
follow this guidance will result in a delay in responding to your 
correspondence. (3) The DHHS Appropriations Act requires that, to the 
greatest extent practicable, all equipment and products purchased with 
funds made available under this award should be American-made. (4) The 
DHHS Appropriations Act requires that, when issuing statements, press 
releases, requests for proposals, bid solicitations, and other 
documents describing projects or programs funded in whole or in part 
with Federal money, the issuance shall clearly state the percentage and 
dollar amount of the total costs of the program or project that will be 
financed with Federal money and the percentage and dollar amount of the 
total costs of the project or program that will be financed by 
nongovernmental sources. (5) A notice in response to the President's 
Welfare-to-Work Initiative was published in the Federal Register on May 
16, 1997. This initiative is designed to facilitate and encourage 
grantees to hire welfare recipients and to provide additional training 
and/or mentoring as needed. The text of the notice is available 
electronically on the OMB home page at http://www.whitehouse.gov/wh/eop/omb.
    3. Reporting: In addition to those listed above, a successful 
applicant will submit quarterly and annual progress reports that 
includes a summary of the local CCOE evaluation and a discussion of 
steps taken to implement each component of the CCOE program and the 
impact of the program on the targeted community/population, an annual 
Financial Status Report, a final Progress Report, a final Financial 
Status Report, and a technical assistance documentation report (How-To 
manual) in the format established by the OWH, in accordance with 
provisions of the general regulations which apply under ``Monitoring 
and Reporting Program Performance,'' 45 CFR part 74, subpart J and part 
92. The purpose of the quarterly and annual progress reports is to 
provide accurate and timely program information to program managers and 
to respond to Congressional, Departmental, and public requests for 
information about the CCOE program. An original and two copies of the 
quarterly progress report must be submitted by January 10, April 10, 
July 10, and August 15. If these dates fall on a Saturday or Sunday, 
the report will be due the following Monday. The last quarterly report 
will serve as the annual progress report and must describe all project 
activities for the entire year. The annual progress report must be 
submitted by August 15 of each year and will serve as the non-competing 
continuation application. Therefore, this report must also include the 
budget request for the next grant year, with appropriate justification, 
and be submitted using Form PHS 5161.

VII. Agency Contact(s)

    For application kits and information on budget and business aspects 
of the application, please contact: Ms. Karen Campbell, Director, OPHS 
Grants Management Office, 1101 Wootton Parkway, Suite 550, Rockville, 
MD 20857. Telephone: (301) 594-0758. E-mail: [email protected].
    Questions regarding programmatic information and/or requests for 
technical assistance in the preparation of the grant application should 
be directed in writing to Ms. Barbara James, Director, National 
Community Centers of Excellence in Women's Health Program, 5600 Fishers 
Lane, Room 16A-55, Rockville, MD 20859. Telephone: (301) 443-1402. E-
mail: [email protected].

VIII. Other Information

    Twelve (12) CCOE programs are currently funded by the OWH. 
Information about these programs may be found at the following Web 
site: http://www.4woman.gov/owh/CCOE/index.htm.
    **The Government is not obligated to make any awards as a result of 
this announcement.

Definitions

    For the purposes of this cooperative agreement program, the 
following definitions are provided: Clinical Care Center: At a minimum, 
each CCOE clinical care center (ccc) must be a physically-identifiable 
space, within the CCOE facility(s), for the delivery of comprehensive 
health care that includes gender and age-appropriate preventive 
services for women. The CCOE clinical care center must have permanent 
signage and be devoted to women-friendly, women-centered, women-
relevant care delivered from a multidisciplinary, holistic, and 
culturally and linguistically appropriate perspective. The CCOE 
clinical care center must also have a clinical intake form, referral 
and tracking system, and procedures for identifying and counting the 
women served by the CCOE by specialty area and for tracking the cost of 
services provided to women who receive interdisciplinary care through 
the CCOE program. Site must be able to differentiate the care provided 
to women counted as CCOE patients compared to non-CCOE patients.
    Community-based: The locus of control and decision-making powers is 
located at the community level, representing the service area of the 
community or a significant segment of the community.
    Community-based organization: Public and private, nonprofit 
organizations that are representative of communities or significant 
segments of communities.
    Community-based research: Community members work with researchers 
to help determine research issues, shape the research process/
objectives, and bring research results back to the community. Community 
members' participation maximizes the potential for exchange in 
knowledge and implementation of research findings. The shared goal is 
to maintain scientific integrity in the research methods, while also 
incorporating the skills, knowledge, and strengths of the participants/
beneficiaries of the research. There is an emphasis on ensuring that 
research results are translated into practice and communicated back to 
the community.
    Community health center: A community-based organization that 
provides comprehensive primary care and preventive services to 
medically underserved populations. This includes but is not limited to 
programs reimbursed through the Federally

[[Page 34373]]

Qualified Health Centers mechanism, Migrant Health Centers, Primary 
Care Public Housing Health Centers, Healthcare for the Homeless 
Centers, and other community-based health centers.
    Comprehensive women's health services: Services including, but 
going beyond traditional reproductive health services to address the 
health needs of underserved women in the context of their lives, 
including a recognition of the importance of relationships in women's 
lives, and the fact that women play the role of health providers and 
decision-makers for the family. Services include basic primary care 
services; acute, chronic, and preventive services including gender and 
age-appropriate preventive services; mental and dental health services; 
patient education and counseling; promotion of healthy behaviors (like 
nutrition, smoking cessation, substance abuse services, and physical 
activity); and enabling services. Ancillary services are also provided 
such as laboratory tests, X-ray, environmental, social referral, and 
pharmacy services.
    Coordinated care: The formal linkages, case management services, 
partnering arrangements, and patient advocate support that enable 
better coordination of women's health resources and help underserved 
women to navigate systems to obtain the comprehensive health services 
they need. Community-based organizations are expected to coordinate 
with State and local health departments, nonprofit organizations, 
academic institutions, or other local organizations in the community as 
appropriate.
    Culturally competent: Information and services provided at the 
educational level and in the language and cultural context that are 
most appropriate for the individuals for whom the information and 
services are intended. Additional information on cultural competency is 
available at the following Web site: http://www.aoa.dhhs.gov/May2001/factsheets/Cultural-Competency.html.
    Cultural perspective: Recognizes that culture, language, and 
country of origin have an important and significant impact on the 
health perceptions and health behaviors that produce a variety of 
health outcomes.
    Enabling services: Services that help women access health care, 
such as transportation, parking vouchers, translation, child care, and 
case management.
    Frontier Area: Areas with low population density that is usually 
fewer than 6-7 persons per square mile.
    Gender-based Care: Highlights inequalities between men and women in 
access to resources to promote and protect health, in responses from 
the health sector, and in the ability to exercise the right to quality 
health care.
    Healthy People 2010: A set of national health objectives that 
outlines the prevention agenda for the Nation. Healthy People 2010 
identify the most significant preventable threats to health and 
establishes national goals for the next ten years. Individuals, groups, 
and organizations are encouraged to integrate Healthy People 2010 into 
current programs, special events, publications, and meetings. 
Businesses can use the framework, for example, to guide worksite health 
promotion activities as well as community-based initiatives. Schools, 
colleges, and civic and faith-based organizations can undertake 
activities to further the health of all members of their community. 
Health care providers can encourage their patients to pursue healthier 
lifestyles and to participate in community-based programs. By selecting 
from among the national objectives, individuals and organizations can 
build an agenda for community health improvement and can monitor 
results over time. More information on the Healthy People 2010 
objectives may be found on the Healthy People 2010 Web site: http://www.health.gov/healthypeople.
    Holistic: Looking at women's health from the perspective of the 
whole person and not as a group of different body parts. It includes 
dental, mental, as well as physical health.
    Integrated: In the CCOE context, the bringing together of the 
numerous spheres of activity (6 CCOE components) that touch women's 
health, including clinical services, research, health training, public 
health outreach and education, leadership development for women, and 
technical assistance. The goal of this approach is to unite the 
strengths of each of these areas, and create a more informed, less 
fragmented, and efficient system of care for underserved women that can 
be replicated in other populations and communities.
    Lifespan: Recognizes that women have different health and 
psychosocial needs as they encounter transitions across their lives and 
that the positive and negative effects of health and health behaviors 
are cumulative across a woman's life.
    Multi-disciplinary: An approach that is based on the recognition 
that women's health crosses many disciplines, and that women's health 
issues need to be addressed across multiple disciplines, such as 
adolescent health, geriatrics, cardiology, mental health, reproductive 
health, nutrition, dermatology, endocrinology, immunology, 
rheumatology, dental health, etc.
    Rural Community: All territory, population, and housing units 
located outside of urban areas and urban cluster.
    Social Role: Recognizes that women routinely perform multiple, 
overlapping social roles that require continuous multi-tasking.
    Sustainability: An organization's or program's staying power: the 
capacity to maintain both the financial resources and the partnerships/
linkages needed to provide the services demanded from a CCOE program. 
It also involves the ability to survive change, incorporate needed 
changes, and seize opportunities provided by a changing environment.
    Underserved Women: In the context of the CCOE model, women who 
encounter barriers to health care that result from any combination of 
the following characteristics: poverty, ethnicity and culture, mental 
or physical state, housing status, geographic location, language, age, 
and lack of health insurance/under-insured.
    Women-centered/women-focused: Addressing the needs and concerns of 
women (women-relevant) in an environment that is welcoming to women, 
fosters a commitment to women, treats women with dignity, and empowers 
women through respect and education. The emphasis is on working with 
women, not for women. Women clients are considered active partners in 
their own health and wellness.

    Dated: June 9, 2004.
Wanda K. Jones,
Deputy Assistant Secretary for Health (Women's Health), Office of 
Public Health and Science.
[FR Doc. 04-13894 Filed 6-18-04; 8:45 am]
BILLING CODE 4150-33-P