[Federal Register Volume 69, Number 139 (Wednesday, July 21, 2004)]
[Notices]
[Pages 43595-43607]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-16545]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Comprehensive STD Prevention Systems, Prevention of STD-Related 
Infertility, and Syphilis Elimination

    Announcement Type: Competing Continuation.
    Funding Opportunity Number: 05004.
    Catalog of Federal Domestic Assistance Number: 93.977.
    Key Dates:
    Application Deadline: September 15, 2004.

I. Funding Opportunity Description

    Authority: This program is authorized under Section 318 (a) (b) 
(c) of the Public Health Service Act [42 U.S.C. Section 247c 
(a)(b)and(c)], as amended. Regulations governing the implementation 
of this legislation are covered under 42 CFR Part 51b, Subparts A 
and D.

    Purpose: The purpose of the program is to support sexually 
transmitted disease (STD) programs in designing, implementing, and 
evaluating Comprehensive STD Prevention Systems (CSPS), including, 
where applicable, initiatives and strategies specific to (1) the 
Infertility Prevention Program (IPP) to prevent STD-related 
infertility; (2) the Syphilis Elimination Program (SE) to eliminate 
syphilis in High Morbidity Areas; and (3) the Gonoccocal Isolate 
Surveillance Project (GISP) to monitor gonoccocal resistance to 
multiple antibiotics. As an optional activity some programs may choose 
to participate in the Quality Evaluation Initiative (QEI) to evaluate 
one program activity. This program announcement addresses the ``Healthy 
People 2010'' focus area of Sexually Transmitted Disease which is aimed 
at addressing health disparities (Areas of Special Emphasis) among 
racial and ethnic minority populations at greater risk for STDs due to 
health disparities, high risk sexual behaviors, the settings in which 
they are found, or because they are at risk for or have acquired other 
diseases. These Areas of Special Emphasis represent high priority 
prevention opportunities and have direct relevance to multiple 
essential functions. The Areas of Special Emphasis identified by each 
grantee will depend on disease and behavioral surveillance (e.g., case 
reports, prevalence monitoring, behavioral assessments) and other 
locally determined data and criteria. While all gender, age, racial, 
cultural, and economic groups are potentially affected by STDS, some 
population groups are disproportionately affected by STDs and their 
complications. As noted in Healthy People 2010, these population groups 
include African Americans, Hispanics, American Indian/Alaskan Natives, 
Asian and Pacific Islanders, women, and adolescents and young adults. 
Groups considered at risk because of high risk sexual behaviors include 
men who have sex with men and persons with multiple sex partners. 
Additionally, high priority prevention opportunities may exist for 
groups that can be accessed in certain settings. These settings 
include, but are not limited to, correctional facilities, HIV 
prevention and care clinics, substance abuse centers or private medical 
care facilities. Finally, opportunities exist for STD programs to 
collaborate and integrate with HIV and hepatitis prevention programs to 
better serve groups that are at risk for or are infected with all of 
these diseases. Examples of collaborative activities include, but are 
not limited to, encouraging medical providers to provide HIV, hepatitis 
and STD screening in high prevalence settings;

[[Page 43596]]

supporting the development and expansion of HIV counseling, testing, 
referral and partner services; and integrating HIV, hepatitis and STD 
prevention messages into health educational materials.
    Development of this program response provides an opportunity to 
conduct short, intermediate, and long term program planning. It may 
serve as the one document that fully describes the goals, objectives, 
activities (present and future) of your comprehensive STD prevention 
program.
    Measurable outcomes of the program will be in alignment with one 
(or more) of the following performance goal(s) for the National Center 
for HIV, STD, and TB Prevention (NCHSTP): (1) Reduce STD rates by 
providing chlamydia and gonorrhea screening, treatment, and partner 
treatment to 50 percent of women in publicly funded family planning and 
STD clinics nationally; (2) Reduce the incidence of primary and 
secondary syphilis; and (3) Reduce the incidence of congenital 
syphilis.
    To ensure quality programs and to measure progress, grantees are 
required to report on a set of performance measures appropriate for 
specific program components. Each grantee will set its own annual 
target level of performance for each performance measure. In future 
years these measures will be refined and enhanced. Guidance on 
performance measures for specific definitions of measures and terms 
will be provided in a separate companion guidance.
    Grantees will be required to specify baseline performance using 
data from the period January 1--June 30, 2004. In addition, grantees 
will be required to specify one-year and four-year goals for each 
performance measure. The discussion should provide a rationale for the 
goals that are set and describe data sources and methods of analysis 
used in setting the baseline performance, one-year and four-year goals. 
If the data sources needed to establish the baseline level are not 
available, the grantee should describe what steps or actions will be 
conducted in Year One to set the baseline level in Year Two.
    Grantees are also expected to provide measurable and quantitative 
four-year project period goals and measurable and quantitative one-year 
budget period objectives when developing their program plans. These 
measurable goals and objectives should relate to the program priorities 
identified and justified in the Background, Need, and Narrative 
sections of the application. If the grantee determines, based on 
project area data, that a specific performance measure is not 
applicable, the grantee must provide adequate justification as to why 
they should not be held accountable for reporting on the measure.
    Grantees are responsible for achieving the target levels of 
performance measures and program goals and objectives established in 
their grant application. If a grantee does not achieve their goals, CDC 
will work with the grantee to determine what steps can be taken to 
improve performance. CDC actions could include providing technical 
assistance, placing conditions or restrictions on the award of funds 
or, with chronic failure to improve, reducing funds.
    In addition to performance measures, four-year goals and one-year 
objectives, grantees are also required to report program data in the 
same format as tables provided. These data tables are listed in two 
sections of this program announcement, (1) Background and Need and (2) 
Progress Reports. In future years of this grant cycle, the data tables 
will be refined and enhanced. Grantees can expect additional data 
reporting requirements to become part of future progress reports.
    Activities for CSPS: Awardee activities for this program are as 
follows:
    The grantee will be responsible for developing a CSPS program plan 
that includes the following activities:
    1. Provide Community and Individual Behavior Change Interventions.
    2. Provide Medical and Laboratory Services.
    3. Ensure Partner Services.
    4. Promote Leadership and Program Management.
    5. Conduct Surveillance and Data Management.
    6. Provide or ensure Training and Professional Development.
    7. Ensure a documented STD Outbreak Response Plan.
    8. Conduct Program Evaluation.
    Activities for IPP: Awardee activities for this program are as 
follows: The grantee will be responsible for developing an IPP program 
plan that includes the following activities:
    1. Ensure clinical services including chlamydia and gonorrhea 
screening and treatment of young, sexually active women and their sex 
partners.
    2. Support laboratory testing.
    3. Develop surveillance and data management systems to ensure 
collection of all CDC core data elements.
    4. Provide program management and leadership.
    5. Ensure provider training.
    Activities for SE: Awardee activities for this program are as 
follows: The grantee will be responsible for developing a SE program 
plan that includes the following activities:
    1. Enhance surveillance.
    2. Strengthen community involvement and partnerships.
    3. Provide rapid outbreak response.
    4. Expand clinical and laboratory services.
    5. Enhance health promotion.
    Activities for GISP:
    1. Collect, handle, and ship specimens.
    2. Report demographic and clinical data.
    Activities for QEI (Optional): In addition to the required 
evaluation activities some grantees may opt to participate in the 
Quality Evaluation Initiative by conducting the following activities:
    1. Evaluate one program intervention.
    2. Report the outcome of the evaluation.

II. Award Information

    Type of Award: Grant.
    Fiscal Year Funds: 2005.
    Approximate Total Funding: $103,000,000.
    Federal funds are intended to supplement (not replace or supplant) 
current state and local resources and must be used to assist state and 
local programs in conducting high-priority activities as described in 
their CSPS, IPP and SE plans.
    CSPS: Approximately $57,000,000 is available (based on FY2004 
financial assistance base-level awards) in FY 2005 to fund 65 awards. 
Included within CSPS is the optional activity, Quality Evaluation 
Initiative (QEI), for which no additional funding is available at this 
time. The average base-level award for CSPS is expected to be $877,000, 
ranging from $24,000 to $5,105,000. Funding estimates may change.
    IPP: Approximately $28,000,000 (based on FY 2004 financial 
assistance base level awards) is available in FY 2005 to fund 65 
awards. Awards will range from $10,700 to $1,910,000.
    SE: Approximately $18,000,000 is available in FY 2005 to supplement 
up to 38 CSPS Project Grants to design, implement, and evaluate 
intervention strategies for syphilis elimination in High Morbidity 
Areas (HMA). It is expected that awards will range from $135,000 to 
$1,900,000.
    GISP: Approximately $460,000 is available in FY 2005. Awards will 
range from $3,000 to $92,000.

Approximate Number of Awards:
    CSPS: 65
    IPP: 65
    SE: 38
    GISP: 28-35
Approximate Average Award:

[[Page 43597]]

    CSPS: $877,000
    IPP: $431,000
    SE: $474,000
    GISP: $19,000
Floor of Award Range:
    CSPS: $24,000
    IPP: $10,700
    SE: $135,000
    GISP: $3,000
Ceiling of Award Range:
    CSPS: $5,105,000
    IPP: $1,910,000
    SE: $1,900,000
    GISP: $92,000

    Anticipated Award Date: January 1, 2005.
    Budget Period Length: 12 months.
    Project Period Length: 4 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

    CDC is specifically authorized to make grants to state and 
political subdivisions of states for research and demonstration 
projects for STD prevention and control; STD screening, treatment, and 
case finding; public information and education programs for STD 
prevention; and education, training, and clinical skills improvement 
for the prevention and control of STDs.
    CSPS: Eligible applicants for the CSPS funds are the 65 official 
public health agencies that are current recipients of project grants 
for Preventive Health Services-Sexually Transmitted Disease Control 
Grants. These applicants have the necessary infrastructure in place to 
perform the activities required and have the experience needed to 
successfully complete the required functions.
    IPP: Eligible applicants for the IPP funds are the 65 official 
public health agencies that are current recipients of project grants 
for Preventive Health Services--Sexually Transmitted Disease Control 
Grants. These applicants have the necessary infrastructure in place to 
perform the activities required and have the experience needed to 
successfully complete the required functions.
    SE: Project areas eligible for Syphilis Elimination funding are 
stratified in three different tiers: (1) Those with greater than 100 
cases of Primary and Secondary (P and S) syphilis in 2003; (2) those 
with greater than 35 cases of P and S and a Male to Female case ratio 
greater than or equal to 2.5 in 2003; (3) those project areas 
previously funded for syphilis elimination who have not reached stable 
reductions of P and S syphilis for the years 2000-2003.
    Project areas with greater than 100 cases of P and S syphilis are: 
Alabama, Arizona, Baltimore, Chicago, California, Florida, Georgia, 
Illinois, Los Angeles, Louisiana, Maryland, Massachusetts, Michigan, 
New Jersey, New York City, North Carolina, Ohio, Puerto Rico, San 
Francisco, Tennessee, Texas.
    Project areas with greater than 35 cases of P and S Syphilis and a 
Male to Female case ratio greater than or equal to 2.5: District of 
Columbia, Minnesota, Virginia, Washington, Philadelphia, Pennsylvania, 
New York State, Oregon.
    Those project areas previously funded for syphilis elimination 
activities 1999-2004 who have not reached stable reductions in P and S 
syphilis for three years 2001-2003 are: Arkansas, Connecticut, Indiana, 
Kentucky, Missouri, Mississippi, Oklahoma, South Carolina, Wisconsin.
    GISP: Current participants include Alabama, Arizona, California, 
Colorado, Florida, Georgia, Hawaii, Illinois, Louisiana, Minnesota, 
Missouri, Nevada, New Mexico, North Carolina, Ohio, Oregon, Texas, 
Washington, Baltimore, Philadelphia, San Francisco, Los Angeles, 
Oklahoma, and Michigan. These applicants have the necessary 
infrastructure in place to perform the activities required and have the 
experience needed to successfully complete the required functions. 
Additional eligible sites may be added as funds become available.
    A Bona Fide Agent is an agency/organization identified by the state 
as eligible to submit an application under the state eligibility in 
lieu of a state application. If you are applying as a bona fide agent 
of a state or local government, you must provide a letter from the 
state or local government as documentation behind the first page of 
your application form.

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.

    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 
5161-1. Application forms, instructions, and appendices 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 Application Submission

    The program announcement is the definitive guide on application 
format, content, and deadlines. It supersedes information provided in 
the application instructions. If there are discrepancies between the 
application form instructions and the program announcement, adhere to 
the guidance in the program announcement.
    You must submit a signed original and two copies of your 
application forms.
    Application: You must include a project narrative with your 
application forms. Your narrative must be submitted in the following 
format:
     Maximum number of pages: CSPS is 40, IPP is 20, SE is 20, 
QEI is five; and GISP is five. 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.
     Paper size: 8.5 by 11 inches.
     Page margin size: One inch.
     Printed only on one side of page.
     Held together only by metal clips; not bound in any other 
way.
     Number all pages.
     Single spaced.
     Include a complete index with page numbers to all parts of 
the application and its appendices.
    Your narrative should address activities to be conducted during the 
entire project period, and must include the following:
    1. Specific one-year interim targets and four-year overall goals.
    2. The discussion should provide a rationale for the targets and a 
description of how each relates to

[[Page 43598]]

Healthy People 2010 Objectives. (Reference-http://www.healthypeople.gov/document/html/volume2/25stds.htm)
    The goals should reflect the vision, priorities and direction of 
the grantee's STD program during the next four-year project period. 
These goals should be supported by background and need descriptions and 
be consistent with the goals of the Division of STD Prevention.
    The narrative must include the following items in the order listed:
1. Executive Summary
    Your executive summary should include a clear and succinct 
description of your program including, but not limited to, funding you 
are applying for (CSPS, IPP, SE, and GISP), program's mission and 
purpose, program structure, significant morbidity and other trends, 
goals of the program for which funding is requested, and key activities 
to meet these goals. Those applicants choosing to participate in the 
QEI initiative should also address this initiative in the executive 
summary.
2. Background and Need for CSPS, IPP, and SE
    This section should describe the grantee's total STD program (not 
just the portion which is federally funded), STD prevention needs, and 
provide a sound platform for proposed CSPS, IPP, and SE funded 
activities. The grantee must include the following:
    a. An overview and update of chlamydia, gonorrhea and syphilis 
morbidity and prevalence (where appropriate) trends by relevant 
characteristics (e.g., gender, age, race/ethnicity, geography) for the 
past five years. Provide current syphilis reactor grid indicating date 
of last assessment and modification. Additionally, complete the 
following four tables separately for each of these time periods: 
calendar year 2003 and the first six months of 2004.

                                               Table 1.--Chlamydia
----------------------------------------------------------------------------------------------------------------
                     Number of Chlamydia tests        Number of positive tests
                   (List as many as appropriate)   (List as many as appropriate)                     Screening
  Provider type  ----------------------------------------------------------------    Test used       criteria
                      Females          Males          Females          Males
----------------------------------------------------------------------------------------------------------------
FP
-----------------
STD
-----------------
Prenatal
-----------------
 
----------------------------------------------------------------------------------------------------------------


                                                                   Table 2.--Gonorrhea
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                             Number of Gonorrhea tests       Number of positive tests
                                                           (List as many as appropriate)   (List as many as appropriate)                     Screening
                      Provider type                      ----------------------------------------------------------------    Test used       criteria
                                                              Females          Males          Females          Males
--------------------------------------------------------------------------------------------------------------------------------------------------------
FP......................................................
---------------------------------------------------------
STD.....................................................
---------------------------------------------------------
Prenatal................................................
---------------------------------------------------------
 
--------------------------------------------------------------------------------------------------------------------------------------------------------


                               Table 3.--Male Primary and Secondary Syphilis Cases
----------------------------------------------------------------------------------------------------------------
                                                            Information about index case
                                   -----------------------------------------------------------------------------
                       Cases with                                Total
   Number of cases       partner       Total        Total      number of     HIV + &                  HIV Status
                      information*   number of    number of    HIV status     MSM**     HIV - & MSM   unknown &
                                        HIV+         HIV-       unknown                                  MSM
----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
 *Partner information is defined as partner information gathered during an interview and/or information gathered
  from a provider even if the case is not interviewed.
**MSM refers to men who have sex with men.


                              Table 4.--Female Primary and Secondary Syphilis Cases
----------------------------------------------------------------------------------------------------------------
                                                                     Information about Index Case
                                                     -----------------------------------------------------------
       Number of Cases           Cases with Partner                                             Total number of
                                    Information*        Total number of     Total number of       HIV status
                                                             HIV+                HIV-               unknown
----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
 * Partner information is defined as partner information gathered during an interview and/or information
  gathered from a provider even if the case is not interviewed.


[[Page 43599]]

    b. Discussion of significant behavioral trends of groups affected 
by STDs (e.g., sexual risk, substance abuse, and health care seeking); 
health services delivery trends (e.g., number of clinics, patients 
seen, relationships with private providers) and program management 
(e.g., organizational structure, funding, federal and local staffing, 
resource limitations) trends over the past five years. Include any 
other relevant information or trends that may be major factors 
affecting STD morbidity within your project area.
    c. Discussion of community involvement and organizational 
partnerships in planning, implementation and evaluation of program 
activities including successes, obstacles, and barriers. Also describe 
collaboration with other governmental and non-governmental entities 
(e.g., regional infertility prevention projects, school-based clinics, 
correctional centers, community planning groups, Indian Health 
Services, tribes, faith-based organizations, STD/HIV Prevention 
Training Centers, AIDS Education and Training Centers).
    d. Discussion of Areas of Special Emphasis: Grantees are expected 
to identify the Areas of Special Emphasis to be addressed through 
program activities and provide a rationale for the selections. The 
grantee must include morbidity, behavioral, or other data/information 
to support the rationale. Examples of information to include are: (1) 
Case rates or prevalence monitoring data; (2) data indicating the 
demographic characteristics of the groups to be reached; (3) behavioral 
or other risk data; or (4) documentation of existing project area 
activities related to the Areas of Special Emphasis chosen.
    e. Statement of grantee's one year interim target and four-year 
overall project period goals for each target. Provide a rationale for 
the targets and a description of how each relates to Healthy People 
2010 Objectives. (Reference: http://www.healthypeople.gov/document/html/volume2/25stds.htm)
3. CSPS Essential Functions
    Following are instructions to complete this section:
    I. Narrative: Describe and discuss the status of each essential 
function as specified under each function. As appropriate, include 
information about how the Areas of Special Emphasis identified in the 
background section are being addressed.
    II. Objectives: List the budget period (one year) program 
objectives for each essential function. They should be consistent with 
grantee's program priorities as related to each function. Assure that 
each objective is specific, measurable, achievable and ambitious, 
relevant, and time bound (SMART). The suggested number of objectives 
for each essential function is one to three.
    III. Activities: Describe the activities that will be conducted to 
achieve the objectives for the next budget period. Include in this 
section any training of program staff or external partners necessary to 
conduct the activities and achieve the objectives.
    IV. Monitoring Plan: A plan should be developed that will monitor 
the activities and progress made toward meeting the objectives 
developed for each essential function. The plan should answer the 
following questions:
    1. What is being done? (e.g., strategy, intervention,activity)
    2. By whom? (e.g., staffing)
    3. For whom? (e.g., target population)
    4. How? (e.g., where, when, how often, how much)
    5. For what specific benefit(s)? (e.g., what are the expected 
results or outcomes?)
    6. What resources are being used? (e.g., staff, materials, money 
etc.)
Essential Functions
    Community and Individual Behavior Change Interventions. Community 
Behavior Change is defined as an intervention conducted for more than 
one person at any given time while Individual Behavior Change is 
defined as an intervention conducted one-on-one. Information on STD 
prevention interventions (or strategies) can include abstinence, 
monogamy, i.e., being faithful to a single sexual partner, or using 
condoms consistently and correctly. These approaches can avoid risk 
(abstinence) or effectively reduce risk for STD (monogamy, consistent 
and correct condom use).
    The components of this essential function are:
    1. Describe how the program implements strategies to target 
individuals, groups or whole communities to build awareness and 
stimulate individual behavior change.
    2. Describe how the program develops networks with experts in the 
fields of communication, behavioral and social science, social 
marketing and advertising to further promote STD prevention messages.
    Medical and Laboratory Services. Medical Services are defined as 
clinical/diagnostic STD services provided by private and public health 
care providers. Laboratory Services are defined as STD testing 
performed at licensed facilities. The components are:
    1. Describe collaboration with non-governmental entities, 
Community-based organizations (CBOs), providers, etc., whose clients 
are at risk for STDs to expand access to care.
    2. Describe how the program assures that the clinical services and 
standards of care in those settings providing STD services are of high 
quality and consistent with CDC's guidelines and recommendations.
    3. Describe screening and counseling of persons at risk for STDs in 
settings where STD services are provided. Screening criteria should be 
based on local morbidity.
    4. Describe how the program assures the availability of on-site, 
``stat'' (immediate) STD laboratory tests (Clinical Laboratory 
Improvement Amendments [CLIA] adherence required) in laboratories in 
public STD clinic settings.
    5. Describe how the program assures that all laboratories adhere to 
reporting requirements including the transmission of quality, complete 
data in a timely manner to providers and the health department.
    There is one performance measure for this essential function. 
Specify baseline performance, one-year, and four-year goals for the 
following measure:
    Proportion of female admittees to large juvenile detention 
facilities tested for chlamydia. (See appendix five for list of 
proposed large county detention facilities by project area that project 
areas may use in responding to this measure.)
    The following information regarding the baseline indicator should 
be provided:
    1. Describe how the baseline was developed.
    2. Describe what data sources were used in setting the baseline.
    3. Describe how the data were analyzed to develop this baseline.
    4. Describe how the one-year and four-year goals were developed.
    5. If the data sources needed to establish the baseline level are 
not available, describe what steps/actions will be conducted in Year 
One to set the baseline level in Year Two.
    Partner Services. Partner Services are those activities offered to 
individuals infected with STDs, their sex partners, and other persons 
who are at increased risk for infection in an effort to prevent further 
transmission of disease. The components are:
    1. Describe confidential notification, appropriate medical 
attention, and needed referrals for sex partners and other high risk 
individuals.

[[Page 43600]]

    2. Describe risk reduction plans to reduce likelihood of acquiring 
future STD/HIV.
    3. Describe identification of communities at risk by analyzing 
information gathered from interviews conducted with patients, partners, 
and others at risk for STD and HIV.
    4. Describe integration or coordination of STD and HIV partner 
services.
    There are five performance measures for this essential function. 
Specify baseline performance, and one-year and four-year goals, for the 
following five measures:
    1. Proportion of primary and secondary syphilis cases interviewed 
within 7, 14, and 30 calendar days from the date of specimen 
collection.
    2. Number of contacts prophylactically treated or newly diagnosed 
and treated within 7, 14 and 30 calendar days from day of interview of 
index case, per case of P and S syphilis.
    3. Number of ``associates'' or ``suspects'' tested, per case of P 
and S syphilis.
    4. Number of ``associates'' or ``suspects'' treated for newly 
diagnosed syphilis, per case of P and S syphilis.
    Project areas receiving syphilis elimination funding are not 
required to report on the following performance measure. For all other 
project areas, when providing required information for this measure, 
describe how the data was analyzed to identify the chosen priority 
population(s).
    5. Proportion of priority gonorrhea cases interviewed within 7, 14 
and 30 days from the date of specimen collection. Priority 
population(s) is to be locally determined (e.g., pregnant women, women 
aged 15-19 years, women of child-bearing age, resistant gonorrhea, MSM, 
etc.)
    The following information regarding each baseline performance 
should be provided:
    1. Describe how the baseline was developed.
    2. Describe what data sources were used in setting the baseline.
    3. Describe how the data were analyzed to develop this baseline.
    4. Describe how the one-year and four-year goals were developed.
    5. If the data sources needed to establish the baseline level are 
not available, describe what steps/actions will be conducted in Year 
One to set the baseline level in Year Two.
    Leadership and Program Management. Leadership is defined as 
providing the vision and context in which management activities are 
implemented. It provides a clear sense of purpose and direction. 
Program Management is defined as overseeing the implementation of 
elements created by leadership. Components of this essential function 
are:
    1. Describe program vision to set the context in which activities 
can be implemented.
    2. Describe implementation of the elements created by leadership 
which include assessment, assurance, and policy development.
    3. Describe dissemination and implementation of national and local 
guidelines and the delivery of high quality STD prevention and clinical 
services.
    4. Describe the development of sound policy that promotes STD 
prevention program goals through solid strategic and operational 
planning.
    5. Describe the involvement of affected communities and other 
relevant partners in strategic and operational planning.
    Surveillance and Data Management. Surveillance is defined as the 
ongoing and systematic collection, analysis, interpretation, and 
dissemination of health data for the purpose of describing and 
monitoring disease trends. Data management is defined as the process of 
collection, analysis, storage, retrieval, and distribution of data. The 
components of this essential function are:
    1. Describe the improvement and maintenance of timely and active 
data and information systems for monitoring STD incidence and 
prevalence, especially in high risk populations and geographic areas.
    2. Describe your system to detect changing patterns, identify 
populations at risk, and provide surveillance data and feedback to 
program managers, community health providers, HIV community planning 
groups, policy makers, family planning partners, correctional 
facilities, Managed Care Organizations, and the lay public.
    There are two performance measures for this essential function. 
Baseline performance for these measures will be provided by CDC. 
Specify one-year and four-year goals for the following two measures.
    1. Proportion of reported cases of gonorrhea, chlamydia, P and S 
syphilis, early latent (EL) syphilis, and congenital syphilis sent to 
CDC via the National Electronic Telecommunications System for 
Surveillance (NETSS) that have complete data for age, race, sex, 
county, and date of specimen collection.
    2. Proportion of reported cases of gonorrhea, chlamydia, P and S 
syphilis, EL syphilis, and congenital syphilis sent to CDC via NETSS 
within 30 and 60 days from the date of specimen collection.
    The following information regarding each baseline indicator should 
be provided:
    1. Describe how the one-year and four-year goals were developed.
    Training and Professional Development. Training is defined as a set 
of activities designed to develop specific skills of workers who are 
required to perform public health prevention functions or tasks. The 
training process includes assessment of staff proficiency and 
identification of training needs; delivery of training to address skill 
and knowledge deficiencies; and evaluation of the effectiveness of the 
training on performance. Professional development is a strategy to 
develop the necessary professional expertise within the targeted 
workforce. It is a broader level of commitment to worker development 
and might include participation in informational seminars and in-
service workshops, formal academic education, and experiential 
activities which aid in the growth of workers' professional expertise. 
Components of this essential function are:
    1. Describe the programs on-going systematic assessment of the 
training needs of staff and external partners.
    2. Describe how the program identifies ongoing training resources.
    3. Describe opportunities for professional development for staff 
members.
    4. Describe training for the professional development of external 
partners including staff and physicians of private medical settings.
    STD Outbreak Response Plan (not included in page limitation). All 
grantees must include an updated STD Outbreak Response Plan as an 
attachment. The plan should include standards for surveillance and 
procedures for analysis of data; a timetable and schedule for review of 
disease trends; the disease thresholds, for gonorrhea and syphilis at a 
minimum, at which the plan is to be initiated; the meaningful 
involvement of the affected community in the effort; staffing 
considerations, including number, disciplinary mix, and specific 
responsibilities of members of response teams; the notification to CDC; 
the evaluation of the effectiveness of the response; and a schedule for 
the periodic review of both the outbreak plan and the surveillance 
system attributes.
4. Quality Evaluation Initiative
    The Quality Initiative, a new component, is intended to assist

[[Page 43601]]

grantees in building local evaluation capacity by improving knowledge 
and skill in the area of program evaluation as practically applied to 
the CSPS. Self-selected grantees are given the opportunity to develop 
plans to conduct an in-depth, science-based evaluation. It is an 
opportunity for a grantee to closely examine a program intervention to 
determine its strengths and weaknesses, its benefits, and its future 
direction. In addition, grantees will be provided technical assistance 
by the Division to assist in the development, implementation, and 
execution of this initiative. During the project period, the grantee 
will have an opportunity to closely examine a program intervention to 
determine its strengths and weaknesses, its benefits, and its future 
direction.
    To express interest in pursuing this quality evaluation initiative 
the grantee should address the following items in their application.
    a. Describe any current program evaluation and quality improvement 
activities the program has or is currently conducting.
    b. Select and briefly describe the rationale for selection of ONE 
program intervention to be evaluated.
    c. List the most important questions to be answered (what does the 
grantee want to learn about the intervention).
    d. Describe what technical assistance your project would need to 
conduct an evaluation.
5. Infertility Prevention Plan
    A comprehensive program plan for infertility prevention should be 
developed based on access to populations at risk, prevalence of 
disease, and available resources (federal, state, local, and private). 
Project areas are expected to develop a program plan that uses the most 
cost-effective approaches available and provide a rationale for the 
approach selected. To improve cost-effectiveness, programs are 
encouraged to expand screening to adolescent women in settings with a 
female prevalence of chlamydia greater than two percent (family 
planning clinics, STD clinics, adolescent health clinics, Indian Health 
Service sites, community health centers, school-based health centers, 
and juvenile detention centers) before screening males. In general, 
screening men is not cost-effective unless the prevalence in the men 
screened is substantially higher than the prevalence in women who can 
be screened (such as seven percent in men vs two percent in women).
    Project area IPP program plans must be developed in collaboration 
with family planning (FP) and laboratory partners. The application must 
include a recently dated letter that provides evidence of collaboration 
and indicates the percentage (at least 50 percent) of IPP funds that 
will support screening and treatment of women and their sex partners in 
Title X family planning settings. If the funds are less than 50 
percent, justification must be provided in the letter. The STD and the 
designated Title X family planning representative must jointly sign the 
letter.
    The project area must provide the Regional IPP Coordinator a draft 
copy of the CSPS Background section, IPP plan, and IPP budget in 
sufficient time to provide feedback prior to local clearance. Any 
comments from the Regional IPP Coordinator received seven days before 
submission to local clearance should be considered by the project area 
for incorporation in the application.
    The following are instructions to complete this section.
    I. Narrative: Describe and discuss the status of each IPP core 
component. As appropriate, include information about how the Areas of 
Special Emphasis identified in the background section are being 
addressed.
    II. Objectives: List the budget period (one year) program 
objectives for each IPP core component. The objectives should be 
consistent with and address relevant priority areas as outlined in the 
2003 Regional IPP Plan Guidance. Assure that each objective is SMART. 
The suggested number of objectives for each core component is one to 
three.
    III. Activities: Describe the required activities to achieve the 
objectives related to the five IPP core components for the next budget 
period (one year). Report on all relevant activities regardless of 
funding source. Activities supported with IPP funds should be clearly 
identified and reported separately. Progress reports should be shared 
with members of the regional advisory committee to keep them abreast of 
program successes and shortfalls.
    IV. Monitoring Plan: A plan should be developed that will monitor 
the activities and progress made toward meeting the objectives 
developed for each IPP core component. The plan should answer the 
following questions:
    1. What is being done? (e.g., strategy, intervention, activity)
    2. By whom? (e.g., staffing)
    3. For whom? (e.g., target population)
    4. How? (e.g., where, when, how often, how much)
    5. For what benefit? (e.g., what are the expected results or 
outcomes?)
    6. What resources are being used? (e.g., staff, materials, money, 
etc.)
    IPP Core Components: Include a description of each of the five IPP 
core components within your narrative.
Clinical Services
     Describe how the program is targeting/expanding chlamydia 
screening to young sexually active women and men at risk for infection 
in family planning, STD and other settings including, but not limited 
to, Indian Health Service sites, migrant and community health centers, 
adolescent clinics, school-based facilities, and juvenile detention 
centers.
     Describe counseling and education strategies to prevent 
and control chlamydia and gonorrhea including (a) the importance of 
partner referral and treatment, (b) the impact of untreated chlamydia 
and repeat chlamydial infections on future fertility and (c) 
information on STD prevention methods (or strategies) such as 
abstinence, monogamy, i.e., being faithful to a single sexual partner, 
or using condoms consistently and correctly.
     Describe monitoring of treatment success.
     Describe monitoring of partner testing and treatment.
     Describe monitoring of regional screening guidelines, 
protocols, and other quality assurance activities.
    Expanded Clinical Services: (If funding allows, describe one or 
more of the components below.)
     Describe how chlamydia screening among private sector 
providers is promoted.
     Describe monitoring of screening coverage in family 
planning and STD clinics (i.e., the number of eligible women screened 
divided by the number of eligible women being seen at a site).
     Describe screening women for gonorrhea (see budget section 
for funding restrictions). To use IPP funds for this purpose, the 
grantee must describe gonorrhea positivity data of one percent or 
greater at the provider sites where services are to be supported. 
Pending further guidance from CDC, a site-specific or age-specific 
gonorrhea prevalence should equal or exceed one percent. Other 
supporting prevalence monitoring data should be included for each 
population or clinic site that can substantiate the need for using IPP 
funds.
     Describe male chlamydia screening activities (see budget 
section for funding restrictions). To use IPP funds for this purpose, 
the grantee must quantify and describe any other male screening 
activities conducted with other funds that are occurring in the project 
area;

[[Page 43602]]

describe what type of activity will be undertaken and type of facility; 
and submit core IPP data elements to regional coordinator.
    There are two performance measures for this IPP Core Component. 
Specify baseline performance, and one-year and four-year goals for the 
following two measures:
    1. Among clients of IPP family planning clinics, the proportion of 
women with positive chlamydia tests that are treated within 14 and 30 
days of the date of specimen collection.
    2. Among clients of IPP family planning clinics, the proportion of 
women with positive gonorrhea tests that are treated within 14 and 30 
days of the date of specimen collection.
    The following information regarding baseline performance for each 
measure should be provided:
    1. Describe how the baseline was developed.
    2. Describe what data sources were used in setting the baseline.
    3. Describe how the data were analyzed to develop this baseline.
    4. Describe how the one-year and four-year goals were developed.
    5. If the data sources needed to establish the baseline level are 
not available, describe what steps/actions will be conducted in Year 
One to set the baseline level in Year Two.
Laboratory Support
     Describe tests used for chlamydia and gonorrhea screening 
including criteria for confirmation testing.
     Describe quality assessment practices to monitor 
performance of laboratories.
     Describe how compliance to regional turnaround time 
standards is monitored.
     Describe how specimen adequacy is monitored.
     Describe methods to increase test sensitivity where 
appropriate (e.g., additional testing within negative gray zone).
     Describe methods to improve test specificity and improve 
positive predictive value.
Surveillance and Data Management
     Describe local information systems used to collect all 
elements of the regional IPP core data set.
     Describe how the project area is using data for program 
planning.
     Describe how adherence to regional or locally developed 
screening criteria is monitored.
     Describe quality assurance activities to monitor 
completeness and timeliness of submission of chlamydia and gonorrhea 
prevalence monitoring data to regional coordinators.
    Expanded Surveillance and Data Management Component: (If funds are 
available)
     Describe local information systems used to collect 
enhanced IPP data elements.
    Program Management and Leadership:
     Describe participation in the regional IPP advisory 
committee and collaboration with state family planning and public 
health laboratory partners.
     Describe how information about the regional project is 
disseminated to local areas.
     Describe how the project area adheres to regionally 
developed protocols (when not in conflict with local policy).
    Expanded Program Management and Leadership: (If funds allow, 
describe the following)
     Describe strategies to optimize program resources (e.g., 
increasing non-federal contribution to project; improving program 
efficiency by increasing use of electronic reporting or reducing 
laboratory costs; negotiating lower test or treatment costs; expanding 
third party reimbursement; or other efforts to increase program 
resources during the reporting period).
Provider Training
    If not addressed in the CSPS training section, describe training 
efforts that support implementation of the IPP and how training needs 
are assessed.
6. Syphilis Elimination (applies only to HMA applicants)
    Following are the instructions to complete this section:
    I. Narrative: Describe and discuss the current status of each SE 
strategy. As appropriate, include information about how the Areas of 
Special Emphasis identified in the Background section are being 
addressed.
    II. Objectives: List the budget period program (one year) 
objectives for each SE strategy. The objectives should reflect your 
program's primary focus as it relates to each of the five strategies. 
Assure that the objectives are SMART. The suggested number of 
objectives for each SE strategy is one to three.
    III. Activities: Describe the activities that will be conducted to 
achieve the objectives for the next budget period. Include in this 
section any training of program staff or external partners necessary to 
conduct the activities and achieve the objectives.
    IV. Monitoring Plan: A plan should be developed that will monitor 
the activities and progress made toward meeting the objectives 
developed for each SE strategy. The plan should answer the following 
questions:
    1. What is being done? (e.g., strategy, intervention, activity)
    2. By whom? (e.g., staffing)
    3. For whom? (e.g., target population)
    4. How? (e.g., where, when, how often, how much)
    5. For what specific benefit? (e.g., what are the expected results 
or outcomes?)
    6. What resources are being used? (e.g., staff, materials, money, 
etc.)
Five Strategies to Eliminate Syphilis
    There are five strategies listed in the National Plan to Eliminate 
Syphilis from the United States. HMAs must address all five strategies.
1. Enhanced Surveillance
    a. Describe how you will enhance the project area surveillance 
system to plan, implement and evaluate syphilis elimination activities. 
This should include a description of how case reporting systems have 
been enhanced and how the systems have been used to estimate the burden 
of disease, define local epidemiology, monitor trends, monitor time 
frames for reporting consistent with those in the National Plan, 
identify high priority populations, identify gaps in health care and 
prevention intervention opportunities, design and evaluate 
interventions, and allocate resources.
    b. Describe syphilis prevalence monitoring activities as outlined 
in the ``Recommendations for Public Health Surveillance of Syphilis in 
the United States'' and how these data have been used to evaluate the 
yield of screening programs, monitor disease burden and trends, 
identify priority populations, evaluate case reporting data, design 
interventions, and allocate resources.
    There are two performance measures for this component. Specify 
baseline performance, and one-year and four-year goals for the 
following two measures:
    1. Proportion of providers or partnerships delivering continuing 
care for >50 HIV+ individuals, who have written protocols for screening 
those clients for syphilis.
    2. Proportion of female admittees entering selected project area 
adult city and county jails that were tested for syphilis. (See 
appendix four for the list of ten adult city and 29 selected county 
jails)
    The following information regarding each baseline indicator should 
be provided:
    1. Describe how the baseline was developed.
    2. Describe what data sources were used in setting the baseline.
    3. Describe how the data were analyzed to develop this baseline.

[[Page 43603]]

    4. Describe how the one-year and four-year goals were developed.
    5. If the data sources needed to establish the baseline level are 
not available, describe what steps/actions will be conducted in Year 
One to set the baseline level in Year Two.
2. Strengthened Community Involvement and Organizational Partnerships
    a. Describe assessment activities that include members of the 
affected communities to determine the non-governmental, community-
based, health and non-health agencies, and institutions that should be 
involved in the development of the syphilis elimination plan. This 
should include a description of how community coalitions and other 
partners are involved to (1) review the epidemiology of syphilis and 
the social and institutional context of its persistence and (2) design 
and implement locally relevant, enhanced syphilis prevention 
interventions and control services identified by community assessment 
activities.
    b. Describe how current STD and HIV prevention activities in the 
project area and other relevant healthcare and non-health sector 
activities (e.g., HIV care providers, community health centers, faith 
communities, substance abuse treatment) are being integrated in the 
syphilis elimination plan. Describe activities to increase partnerships 
to improve the availability of and accessibility to quality preventive 
care services for high priority populations. If obstacles or barriers 
exist describe the situation and activities to overcome the situation.
3. Syphilis Outbreak Response Plan
    In addition to addressing syphilis in the STD Outbreak Response 
Plan (required appendix), the grantee should provide a rationale for 
the area-specific syphilis threshold cited in the Plan. The grantee 
should also briefly describe whether their Outbreak Response Plan had 
been activated and evaluated for the period of time between January 
2003 and June 2004. For example, How well did it work? Was it necessary 
to modify the plan? What were the outcomes of activating the plan and 
related interventions? (e.g., increased awareness, reduced incidence, 
what methodology was used to evaluate the activation of the plan?)
4. Expanded Clinical and Laboratory Services
    a. Develop, implement, and evaluate enhanced syphilis prevention 
interventions and control systems. Recipients must be able to provide 
accessible and timely client-centered counseling, screening and 
treatment services in sites frequented by priority populations.
    b. Working with community and institutional partners, grantees must 
determine which of the following essential interventions are needed to 
assure elimination of syphilis in their local situation. Recipients 
must be able to execute and evaluate the identified interventions. 
Interventions include: (1) Enhanced clinical and laboratory services to 
assure high quality, accessible biomedical services; (2) screening in 
priority population settings that are determined by each project area 
based on current data analyses and input from community partners 
(settings could include HIV prevention clinics, corrections, drug 
treatment, emergency rooms, homeless shelters, local communities, and 
other community appropriate settings); (3) improved partner services, 
including partner notification, identification and provision of 
services within social-sexual networks, and high quality disease 
investigation services linking to quality clinical and counseling 
services; and (4) community-based services for priority populations. 
Community-based services should include access to disease screening and 
treatment, referral for other clinical services as appropriate, 
outreach to priority populations, prevention education, and condom 
distribution.
5. Enhanced Health Promotion
    a. Expand community and individual risk reduction interventions to 
lower the acquisition and transmission of syphilis through delivery of 
theory-based behavior change interventions targeting priority 
populations.
    b. Develop systematic communication and media strategies (print, 
television, radio and local CBO outreach activities to assure 
dissemination of syphilis elimination messages.

    Note: Information on syphilis prevention methods (or strategies) 
can include abstinence, monogamy, i.e., being faithful to a single 
sexual partner, or using condoms consistently and correctly. These 
approaches can avoid risk (abstinence) or effectively reduce risk 
for syphilis (monogamy, consistent and correct condom use).

7. Gonococcal Isolate Surveillance Program (Applies Only to GISP 
Applicants)
    Provide a narrative that includes the following:
     Describe enrollment strategy. Specifically, describe how 
applicant intends to reach a goal of 25 isolates per month.
     Describe procedures for isolate collection, handling and 
shipping.
     Describe patient data applicant intends to collect and the 
plan for submitting data to CDC in a timely fashion.
     Where appropriate, describe procedures for determining 
beta-lactamase production and antimicrobial susceptibilities of GISP 
isolates.
     Where appropriate, discuss timeliness of isolate testing 
and submission of results, storage or duplicate isolates, use of 
control strains, proficiency testing, and timeliness of CASPIR isolate 
submission.
8. Budget and Budget Justifications (Not Included in Page Limit)
    An individual line-item budget and budget justification must be 
submitted for each funding source for which your program is applying. 
The budget and justifications should reflect year one of operation. All 
requested costs should be consistent with program objectives and 
activities, especially those related to requests for personnel, and 
contracts. For all contracts, provide: (1) Name of contractor, (2) 
period of performance, (3) method of selection (e.g., competitive or 
sole source), (4) description of activities, (5) reason for contracting 
activities, and (6) itemized budget. For personnel requests, include 
the following: Name, position title, salary, percentage of effort, and 
amount requested. For non-federal resources: Document the resources 
expended (see Form 424A, Section C, Non-Federal Resources). Grantees 
must complete appendix number four, Table of staff percentage of time 
spent on HIV activities and appendix number five, Table of state and 
local contributions to STD prevention efforts. Funding restrictions, 
which must be taken into account while writing your budget, are listed 
in section ``IV.5. Funding Restrictions'' of this announcement.

    Note: Any information systems development supported through this 
cooperative agreement should be done according to the Public Health 
Information Network (PHIN) architecture specifications. The creation 
of standards-based, interoperable public health information systems 
is the goal of these specifications. Two of the chief components of 
the PHIN initiative are affected by or affect almost any information 
systems development project and special attention should be paid to 
them. These are standard messaging (data exchange) formats and 
content and standard vocabulary code sets. Examples of projects 
heavily affected by these components are surveillance systems 
developed according to National Electronic Disease Surveillance

[[Page 43604]]

System (NEDSS) standards and Laboratory Information Management 
System (LIMS) implementations. For more information on Public Health 
Information Network (PHIN), the PHIN architecture, PHIN messaging, 
and PHIN standards, functions, and specifications, go to http://www.cdc.gov.phin/.

    Additional information must be included in the application 
appendices. The appendices will not be counted toward the narrative 
page limit. This additional information includes:
    1. Curriculum Vitae of Project Director.
    2. Syphilis Reactor Grid.
    3. Outbreak Response Plan.
    4. IPP letter of support.
    5. Table 1. Percentage Direct Assistance/Financial Assistance (DA/
FA) Staff Time Attributed to STD and HIV Activities.
    6. Table 2. State and Local Contribution for STD Prevention by 
Budget Category.
    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 the ``Administrative 
and National Policy Requirements'' section of this announcement.

IV.3. Submission Dates and Times

    Application Deadline Date: September 15, 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 format, 
content, and deadlines. 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

    Your application is subject to Intergovernmental Review of Federal 
Programs, as governed by Executive Order (EO) 12372. This order sets up 
a system for state and local governmental review of proposed federal 
assistance applications. You should contact your state single point of 
contact (SPOC) as early as possible to alert the SPOC to prospective 
applications, and to receive instructions on your state's process. 
Click on the following link to get the current SPOC list: http://www.whitehouse.gov/omb/grants/spoc.html.

IV.5. Funding Restrictions

    Funding restrictions, which must be taken into account while 
writing your budget, are as follows:
CSPS
    1. Grant funds may be used for costs associated with organizing and 
conducting STD Prevention activities described in the Application 
Structure and Content section of this announcement. Funds cannot be 
used to supplant existing state or local funds.
    2. When federal funds are used to develop or purchase STD health 
education materials, they shall contain medically accurate information 
regarding the effectiveness or lack of effectiveness in preventing the 
STD the materials are designed to address.
IPP
    1. In consultation with the Project Area's Title X family planning 
grantee(s), at least 50 percent of the total IPP funds must be directed 
to support screening of women and their partners in Title X family 
planning programs. The level of support must be documented in a current 
letter signed by the STD Director and the designated Title X family 
planning grantee representative. If less than 50 percent (of the 
funds), the letter must include an explanation of the alternate 
arrangement.
    2. Up to ten percent of the total IPP funds can be used to support 
gonorrhea screening of women. The collaboration letter from the STD 
Program Director and Title X designated representative must indicate 
how the Title X Family Planning partner(s) was involved in these 
decisions. The grantee must include a detailed budget that delineates 
the amount of IPP funds allocated for gonorrhea screening activities.
    3. Up to 20 percent of the total IPP funds can be used to support 
male screening. The collaboration letter from the STD Program Director 
and Title X designated representative must indicate how the Title X 
Family Planning partner(s) was involved in these decisions. The grantee 
must include a detailed line item budget that delineates the amount of 
IPP funds allocated for male screening and treatment activities.
    4. IPP funds can be used to support testing, treatment and 
counseling services provided to the partners of individuals with 
chlamydia. However, support of Disease Intervention Specialists for 
these partner services is restricted pending the development of CDC 
guidance regarding such services.
SE
    1. HMAs may use funds for infrastructure development to support 
syphilis elimination activities.
    2. Thirty percent of funds must be awarded to community 
organizations that serve affected populations. Community organizations 
are those that are within reasonably circumscribed geographic areas in 
which there is a sense of interdependence and belonging. These 
organizations have access to, and history and social credibility with, 
persons and groups affected by syphilis. They are able to provide 
culturally competent and relevant interventions. Grantees must report 
on activities of these funded organizations in future project period 
progress reports.
    If you are requesting indirect costs in your budget, you must 
include a copy

[[Page 43605]]

of your indirect cost rate agreement. If your indirect cost rate is a 
provisional rate, the agreement must be less than 12 months of age.
    Awards will not allow reimbursement of pre-award costs.
    Guidance for completing your budget can be found on the CDC 
website, at the following Internet 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-
PA 05004, 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 grant. 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.
    All applications will receive a technical acceptability review 
(TAR). Your application will be evaluated against the criteria listed 
in ``Section IV.2. Content and Form of Application Submission'' of this 
announcement.
    The following review criteria apply to the QEI:
    1. Plan Description (60 points)
    Does the applicant describe a plan to identify and develop an 
evaluation of one program activity using an appropriate framework, 
e.g., CDC's Framework for Program Evaluation in Public Health Practice, 
that is specific to STD prevention and control? Is the plan complete, 
sound, practical, and able to be generalized to other STD prevention 
programs.
    2. Capacity (40 points)
    Does the applicant provide a staffing plan that demonstrates an 
understanding of the labor requirements for this activity including 
staff member(s) name with resume or summary of their program evaluation 
experience and other relevant experience? Does the applicant clearly 
state a commitment to produce a high quality evaluation product?
    The following review criteria apply to GISP:
    1. Enrollment strategy (40 points)
    Does the applicant describe an enrollment strategy that 
demonstrates likelihood that goal of 25 isolates per month will be 
reached?
    2. Procedures (40 points)
    Does the applicant describe appropriate procedures for isolate 
collection, handling and shipping? Does the applicant describe, if 
applicable, procedures for determining beta-lactamase production and 
antimicrobial susceptibilities of GISP isolates? Does the applicant 
discuss, if applicable, timeliness of isolate testing and submission of 
results, storage or duplicate isolates, use of control strains, 
proficiency testing, and timeliness of CDC and ATSDR Specimen 
Packaging, Inventory, and Repository (CASPIR) isolate submission.
    3. Data plan (20 points)
    Does the applicant describe data to be collected and plan for 
timely submission of data?
    4. Budget (not scored)

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, 
Division of STD Prevention. Incomplete 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 Date

    Anticipated award date is January 1, 2005.

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 or 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-1 Human Subjects Requirements.
     AR-2 Requirements for Inclusion of Women and Racial and 
Ethnic Minorities in Research.
     AR-7 Executive Order 12372.
     AR-8 Public Health System Reporting Requirements.
     AR-10 Smoke-Free Workplace Requirements.
     AR-11 Healthy People 2010.
     AR-12 Lobbying Restrictions.
     AR-14 Accounting System Requirements.
     AR-22 Research Integrity.
     AR-23 States and Faith-Based Organizations.
     AR-24 Health Insurance Portability and Accountability Act 
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 copies of the 
following reports:
    1. Interim progress report is due on or before September 15 of each 
year. The progress report will serve as your non-competing continuation 
application, and must contain the following elements:
    a. Current Budget Period Activities Objectives.
    b. Current Budget Period Financial Progress.
    c. New Budget Period Program Proposed Activity Objectives.
    d. Detailed Line-Item Budget and Justification.
    e. Additional Requested Information. The following data tables are 
required for the first six months of the budget period.

[[Page 43606]]



                                                                   Table 1.--Chlamydia
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                             Number of Chlamydia tests       Number of positive tests
                                                           (List as many as appropriate)   (List as many as appropriate)                     Screening
                      Provider type                      ----------------------------------------------------------------    Test used       criteria
                                                              Females          Males          Females          Males
--------------------------------------------------------------------------------------------------------------------------------------------------------
FP......................................................
---------------------------------------------------------
STD.....................................................
---------------------------------------------------------
Prenatal................................................
---------------------------------------------------------
 
--------------------------------------------------------------------------------------------------------------------------------------------------------


                                                                   Table 2.--Gonorrhea
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                             Number of Gonorrhea tests       Number of positive tests
                                                           (List as many as appropriate)   (List as many as appropriate)                     Screening
                      Provider type                      ----------------------------------------------------------------    Test used       criteria
                                                              Females          Males          Females          Males
--------------------------------------------------------------------------------------------------------------------------------------------------------
FP......................................................
---------------------------------------------------------
STD.....................................................
---------------------------------------------------------
Prenatal................................................
---------------------------------------------------------
 
--------------------------------------------------------------------------------------------------------------------------------------------------------


                               Table 3.--Male Primary and Secondary Syphilis Cases
----------------------------------------------------------------------------------------------------------------
                                                            Information about Index Case
                                   -----------------------------------------------------------------------------
                       Cases with                                Total
   Number of cases       partner       Total        Total      number of                              HIV status
                      information*   number of    number of    HIV Status  HIV + & MSM   HIV- & MSM   unknown &
                                        HIV+         HIV-       Unknown                                  MSM
----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
 * Partner information is defined as partner information gathered during an interview and/or information
  gathered from a provider even if the case is not interviewed.


                              Table 4.--Female Primary and Secondary Syphilis Cases
----------------------------------------------------------------------------------------------------------------
                                                                     Information about Index Case
                                                     -----------------------------------------------------------
       Number of cases           Cases with partner                                             Total number of
                                    information*        Total number of     Total number of       HIV status
                                                             HIV +                HIV               unknown
----------------------------------------------------------------------------------------------------------------
 
----------------------------------------------------------------------------------------------------------------
 * Partner information is defined as partner information gathered during an itnerview and/or information
  gathered from a provider even if the case is not interviewed.

    f. Measures of Effectiveness. The following performance measures 
are required for the first six months of the budget period.
    1. Proportion of female admittees to large juvenile detention 
facilities tested for chlamydia.
    2. Proportion of primary and secondary (P and S) syphilis cases 
interviewed within 7, 14, and 30 calendar days from the date of 
specimen collection.
    3. Number of contacts prophylactically treated or newly diagnosed 
and treated within 7, 14 and 30 calendar days from day of interview of 
index case, per case of P and S syphilis.
    4. Number of ``associates'' or ``suspects'' tested, per case of P 
and S syphilis.
    5. Number of ``associates'' or ``suspects'' treated for newly 
diagnosed syphilis, per case of P and S syphilis.
    6. Proportion of ``priority'' gonorrhea cases interviewed within 7, 
14 and 30 days from the date of specimen collection. Priority 
population(s) is to be locally determined (e.g., pregnant women, women 
aged 15-19 years, women of child-bearing age, resistant gonorrhea, MSM, 
etc.)
    7. Proportion of reported cases of gonorrhea, chlamydia, P and S 
syphilis, EL syphilis, and congenital syphilis sent to CDC via NETSS 
that have complete data for age, race, sex, county, and date of 
specimen collection.
    8. Proportion of reported cases of gonorrhea, chlamydia, P and S 
syphilis, EL syphilis, and congenital syphilis sent to CDC via NETSS 
within 30 and 60 days from the date of specimen collection.
    9. Among clients of IPP family planning clinics, the proportion of 
women with positive CT tests that are

[[Page 43607]]

treated within 14 and 30 days of date of specimen collection.
    10. Among clients of IPP family planning clinics, the proportion of 
women with positive gonorrhea tests that are treated within 14 and 30 
days of date of specimen collection.
    11. Proportion of providers or partnerships delivering continuing 
care for >50 HIV+ individuals, who have written protocols for screening 
those clients for syphilis.
    12. Proportion of female admittees entering selected project area 
adult city and county jails that were tested for syphilis.
    2. Financial status report is due March 31 of each year.
    3. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    These reports must be sent to the Grants Management 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: Kim Seechuk, Deputy 
Branch Chief, Program Development and Support Branch, Division of STD 
Prevention, 1600 Clifton Road, MS E-27, Atlanta, GA 30333, Telephone: 
404-639-8339, E-mail: [email protected].
    For financial, grants management or budget assistance, contact: 
Gladys Gissentanna, Grants Management Specialist, CDC Procurement and 
Grants Office, 2920 Brandywine Road, Atlanta, GA 30341, Telephone: 770-
488-2753, E-mail: [email protected].

VIII. Other Information

    Appendices can be found with this announcement on the CDC Web site 
at http://www.cdc.gov/od/pgo/funding/grantmain.htm Appendix contains:
    (1) Description of SMART Objectives
    (2) Quality Initiative: Examples of Interventions to Evaluate
    (3) Outline for Grant Application
    (4) List of 21 adult city and 30 selected county jails
    (5) Percentage DA/FA Staff Time Attributed to STD and HIV 
Activities
    (6) State and Local Contribution for STD Prevention by Budget 
Category
    See http://www.nchstp.cdc.gov/std/ for: (1) Division of STD Program 
Operations Guidelines, (2) National Plan to Eliminate Syphilis from the 
United States, and (3) Regional Infertility Plan Guidance.

    Dated: July 15, 2004.
William P. Nichols,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 04-16545 Filed 7-20-04; 8:45 am]
BILLING CODE 4163-18-P