[Federal Register Volume 69, Number 145 (Thursday, July 29, 2004)]
[Notices]
[Pages 45330-45334]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-17280]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Full Access Home-Based VCT Using Outreach Teams in Two Districts 
in the Republic of Uganda

    Announcement Type: New.
    Funding Opportunity Number: 04228.
    Catalog of Federal Domestic Assistance Number: 93.941.
    Key Dates:
    Application Deadline: August 30, 2004.

I. Funding Opportunity Description

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

    Purpose: The Centers for Disease Control and Prevention (CDC) 
announces the availability of fiscal year (FY) 2004 funds for a 
cooperative agreement program for Full Access Home-Based Voluntary 
Counseling and Testing (VCT) using Outreach Teams in Two Districts in 
the Republic of Uganda.
    The overall aim of this program is to implement a model of rapid 
home-based VCT, which provides access for the entire population of a 
district to VCT within their community of residence. The service would 
include referral of those testing positive to sources of basic 
preventative care and palliative care.

[[Page 45331]]

The provision of antiretroviral therapy (ART) is not part of this 
program.
    The United States Government seeks to reduce the impact of HIV/AIDS 
in specific countries within sub-Saharan Africa, Asia and the Americas. 
The President's Emergency Plan for AIDS Relief (PEPFAR) encompasses 
HIV/AIDS activities in more than 75 countries and focuses on 14 
countries including Uganda to develop comprehensive and integrated 
prevention, care and treatment programs. CDC has initiated its Global 
AIDS Program (GAP) to strengthen capacity and expand activities in the 
areas of: (1) HIV primary prevention; (2) HIV care, support and 
treatment; and (3) capacity and infrastructure development including 
surveillance. Targeted countries represent those with the most severe 
epidemics and the highest number of new infections. They also represent 
countries where the potential impact is greatest and where the United 
States government agencies are already active. Uganda is one of those 
countries.
    CDC's mission in Uganda is to work with Ugandan and international 
partners to develop, evaluate, and support effective implementation of 
interventions to prevent HIV and related illnesses and improve care and 
support of persons with HIV/AIDS.
    VCT services are only available at a five percent of health 
facilities (Uganda Health Facilities Survey 2002). The most recent 
Demographic and Health Survey in Uganda indicated that 70 percent of 
people would like to receive HIV testing, but only 10 percent reported 
that they had been tested. Evidence from studies in several districts 
suggests that when offered VCT in their homes between 50 and 90 percent 
utilize the service. If cost effective procedures of offering access to 
VCT to the whole population over a relatively short period could be 
developed, then this would provide an important strategy for averting 
infections and providing timely care to people living with HIV/AIDS 
(PLWHAs).
    The purpose of this program is to provide HIV counseling and 
testing services to all adults and potentially all children less than 
five years of age residing in two districts. This program will operate 
over a period of 12 months in order to evaluate the experience and 
produce guidelines for cost effective expansion of the program to other 
districts in Uganda. It is expected that this first phase of the 
program, including preparation and evaluation, would last 18 months. 
The program would include referrals to local care providers offering 
basic preventative care, palliative care, and, if available 
antiretroviral treatment, to persons with HIV/AIDS in the target 
districts, but without taking on long term responsibility for financial 
support of care provision.
    The measurable outcomes of the program will be in alignment with 
goals of the Global AIDS Program (GAP) to reduce HIV transmission and 
improve care of persons living with HIV. They also will contribute to 
the goals of the PEPFAR which are: within five years treat more than 
two million HIV-infected persons with effective combination anti-
retroviral therapy; care for seven million HIV-infected and affected 
persons including those orphaned by HIV/AIDS; and prevent ten million 
new infections. Specific measurable outcomes of this program should 
include, but not be limited to, the number, age and sex of clients 
(individual and couples) provided with HIV counseling and testing (HIV 
CT), the percentage coverage of the population by HIV CT, unrecognized 
infections discovered, the cost per client service and per unrecognized 
infection, and the number of persons with HIV successfully referred to 
an effective care provider.

Activities

    Awardee activities for this program are as follows:
    a. Identify project staffing needs; hire and train staff.
    b. Identify vehicles, furnishings, fittings, equipment, computers 
and other fixed assets procurement needs of the project and 
implementing partners, and acquire from normal sources.
    c. Establish suitable administrative and financial management 
structures including a project office if required.
    d. Work with the districts to implement home-based HIV counseling 
and testing in such a manner that the coverage of the district's 
population is progressive, predictable and comprehensive, reaching all 
communities before 12 months have elapsed from the start of VCT 
delivered under this program.
    e. Work with district stakeholders to develop an effective referral 
system to care providers for those testing positive.
    f. Ensure that all persons testing positive receive information 
about a basic preventive care package and referral to an effective care 
provider.
    g. Support the development of a simple data collection system, 
integrated within the general Health Management Information System 
(HMIS) that reflects useful information specifically related to VCT 
activities and PEPFAR reporting requirements. For program evaluation 
purposes, some information related to demographic and behavioral risk 
factors for HIV should be collected.
    h. Ensure that a commodities supply and management system is 
operational in respect to test kits and other necessary items.
    i. Develop a simple quality assurance system for HIV counseling and 
testing in a home-based setting.
    j. Evaluate the activity and disseminate conclusions.
    k. Develop and produce guidelines and training manuals in 
collaboration with Ministry of Health and other stakeholders relating 
to full access HIV CT.
    l. Ensure that the above activities are undertaken in a manner 
consistent with the national HIV/AIDS strategy.
    In a cooperative agreement, CDC staff is substantially involved in 
the program activities, above and beyond routine grant monitoring.
    CDC Activities for this program are as follows:
    a. Provide technical assistance, as needed, in the development of 
training curricula, materials, and diagnostic therapeutic guidelines.
    b. Collaborate with the recipient, as needed, in the development of 
an information technology system for medical record keeping and 
information access and in the analysis of data derived from those 
records.
    c. Assist, as needed, in the monitoring and evaluation of the 
program and in development of further appropriate initiatives.
    d. Assist, as needed, in appropriate analysis and interpretation of 
program evaluation data collected during training sessions.
    e. Provide input, as needed, into the criteria for selection of 
staff and non-staff implementing personnel for the VCT program.
    f. Provide input into the overall program strategy.
    g. Collaborate, as needed, with the recipient in the selection of 
key personnel to be involved in the activities to be performed under 
this agreement including approval of the overall manager of the 
program.
    Technical assistance and training may be provided directly by CDC 
staff or through organizations that have successfully competed for 
funding under a separate CDC contract.

II. Award Information

    Type of Award: Cooperative Agreement.
    CDC involvement in this program is listed in the Activities Section 
above.
    Fiscal Year Funds: 2004.

[[Page 45332]]

    Approximate Total Funding: $2,580,000.
    Approximate Number of Awards: Two.
    Approximate Average Award: $645,000 per award (This amount is for 
the first 12-month budget period, and includes only direct costs).
    Floor of Award Range: None.
    Ceiling of Award Range: $1,290,000.
    Anticipated Award Date: September 1, 2004.
    Budget Period Length: 12 months.
    Project Period Length: Two years.
    Throughout the project period, CDC's commitment to continuation of 
awards will be conditioned on the availability of funds, evidence of 
satisfactory progress by the recipient (as documented in required 
reports), and the determination that continued funding is in the best 
interest of the Federal Government.

III. Eligibility Information

III.1. Eligible Applicants

    Applications may be submitted by public nonprofit organizations, 
private nonprofit organizations, universities, colleges, research 
institutions, hospitals, and faith-based organizations that meet the 
following criterion:
    1. Have at least three years of documented HIV counseling and 
testing program experience in Africa.

III.2. Cost Sharing or Matching

    Matching funds are not required for this program.

III.3. Other

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

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

    Private, non-profit organizations are encouraged to submit with 
their applications the survey located under ``Grant Related Documents 
and Forms'' titled ``Survey for Private, Non-Profit Grant Applicants'' 
at http://www.acf.hhs.gov/programs/ofs/final_fy04_424_survey.doc.

IV. Application and Submission Information

IV.1. Address To Request Application Package

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

IV.2. Content and Form of Submission

    Application: You must submit a project narrative with your 
application forms. The narrative must be submitted in the following 
format:
     Maximum number of pages: 25. If your narrative exceeds the 
page limit, only the first pages, which are within the page limit, will 
be reviewed.
     Font size: 12 point unreduced.
     Double spaced.
     Paper size: 8.5 by 11 inches.
     Page margin size: One inch.
     Printed only on one side of page.
     Held together only by rubber bands or metal clips; not 
bound in any other way.
     All pages should be numbered, and a complete index to the 
application and any appendices must be included.
     Submitted in English.
    Your narrative should address activities to be conducted over the 
entire project period, and must include, at a minimum, the following 
items in the order listed: a plan, objectives, activities, methods, an 
evaluation framework, a budget highlighting any supplies mentioned in 
the Program Requirements and any proposed capital expenditure.
    Additional information is optional and may be included in the 
application appendices. The appendices will not be counted toward the 
narrative page limit. Additional information could include but is not 
limited to: organizational charts, curriculum vitas, letters of 
support, etc.
    The budget justification will not be counted in the page limit 
stated above.
    You are required to have a Dun and Bradstreet Data Universal 
Numbering System (DUNS) number to apply for a grant or cooperative 
agreement from the Federal government. The DUNS number is a nine-digit 
identification number, which uniquely identifies business entities. 
Obtaining a DUNS number is easy and there is no charge. To obtain a 
DUNS number, access www.dunandbradstreet.com or call 1-866-705-5711.
    For more information, see the CDC Web site at: http://www.cdc.gov/od/pgo/funding/pubcommt.htm. If your application form does not have a 
DUNS number field, please write your DUNS number at the top of the 
first page of your application, and/or include your DUNS number in your 
application cover letter.
    Additional requirements that may require you to submit additional 
documentation with your application are listed in section ``VI.2. 
Administrative and National Policy Requirements.''

IV.3. Submission Dates and Times

    Application Deadline Date: August 30, 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 carrier's guarantee. If the documentation 
verifies a carrier problem, CDC will consider the application as having 
been received by the deadline.
    This announcement is the definitive guide on application submission 
address and deadline. It supersedes information provided in the 
application instructions. If your application does not meet the 
deadline above, it will not be eligible for review, and will be 
discarded. You will be notified that your application did not meet the 
submission requirements.
    CDC will not notify you upon receipt of your application. If you 
have a question about the receipt of your application, first contact 
your courier. If you still have a question, contact the PGO-TIM staff 
at: 770-488-2700. Before calling, please wait two to three days after 
the application deadline. This will allow time for applications to be 
processed and logged.

[[Page 45333]]

IV.4 Intergovernmental Review of Applications

    Executive Order 12372 does not apply to this program.

IV.5. Funding Restrictions

Funding Restrictions
    Restrictions, which must be taken into account while writing your 
budget, are as follows:
     Funds may not be used for any new construction.
     Antiretroviral Drugs--The purchase of antiretrovirals, 
reagents, and laboratory equipment for antiretroviral treatment 
projects require pre-approval from the HHS/CDC Officials.
     Needle Exchange--No funds appropriated under this Act 
shall be used to carry out any program of distributing sterile needles 
or syringes for the hypodermic injection of any illegal drug.
     Funds may be spent for reasonable program purposes, 
including personnel, training, travel, supplies and services. Equipment 
may be purchased and renovations completed if deemed necessary to 
accomplish program objectives; however, prior approval by CDC officials 
must be requested in writing.
     All requests for funds contained in the budget shall be 
stated in U.S. dollars. Once an award is made, CDC will not compensate 
foreign grantees for currency exchange fluctuations through the 
issuance of supplemental awards.
     The costs that are generally allowable in grants to 
domestic organizations are allowable to foreign institutions and 
international organizations, with the following exception: With the 
exception of the American University, Beirut, and the World Health 
Organization, Indirect Costs will not be paid (either directly or 
through sub-award) to organizations located outside the territorial 
limits of the United States or to international organizations 
regardless of their location.
     The applicant may contract with other organizations under 
this program; however, the applicant must perform a substantial portion 
of the activities, including program management and operations, and 
delivery of prevention and care services for which funds are required).
     Prostitution and Related Activities--The U.S. Government 
is opposed to prostitution and related activities, which are inherently 
harmful and dehumanizing, and contribute to the phenomenon of 
trafficking in persons.
    Any entity that receives, directly or indirectly, U.S. Government 
funds in connection with this document (``recipient'') cannot use such 
U.S. Government funds to promote or advocate the legalization or 
practice of prostitution or sex trafficking. Nothing in the preceding 
sentence shall be construed to preclude the provision to individuals of 
palliative care, treatment, or post-exposure pharmaceutical 
prophylaxis, and necessary pharmaceuticals and commodities, including 
test kits, condoms, and, when proven effective, microbicides. A 
recipient that is otherwise eligible to receive funds in connection 
with this document to prevent, treat, or monitor HIV/AIDS shall not be 
required to endorse or utilize a multisectoral approach to combating 
HIV/AIDS, or to endorse, utilize, or participate in a prevention method 
or treatment program to which the recipient has a religious or moral 
objection. Any information provided by recipients about the use of 
condoms as part of projects or activities that are funded in connection 
with this document shall be medically accurate and shall include the 
public health benefits and failure rates of such use.
    In addition, any foreign recipient must have a policy explicitly 
opposing, in its activities outside the United States, prostitution and 
sex trafficking.
    The following definitions apply for purposes of this clause:
     Sex trafficking means the recruitment, harboring, 
transportation, provision, or obtaining of a person for the purpose of 
a commercial sex act. 22 U.S.C. 7102(9).
     A foreign recipient includes an entity that is not 
organized under the laws of any State of the United States, the 
District of Columbia or the Commonwealth of Puerto Rico. Restoration of 
the Mexico City Policy, 66 FR 17303, (March 28, 2001).
    All recipients must insert provisions implementing the applicable 
parts of this section, ``Prostitution and Related Activities,'' in all 
sub agreements under this award. These provisions must be express terms 
and conditions of the sub agreement, acknowledge that each 
certification to compliance with this section, ``Prostitution and 
Related Activities,'' are a prerequisite to receipt of U.S. government 
funds in connection with this document, and must acknowledge that any 
violation of the provisions shall be grounds for unilateral termination 
of the agreement prior to the end of its term. In addition, all 
recipients must ensure, through contract, certification, audit, and/or 
any other necessary means, all the applicable requirements in this 
section, ``Prostitution and Related Activities,'' are met by any other 
entities receiving U.S. government funds from the recipient in 
connection with this document, including without limitation, the 
recipients' sub-grantees, sub-contractors, parents, subsidiaries, and 
affiliates. Recipients must agree that HHS may, at any reasonable time, 
inspect the documents and materials maintained or prepared by the 
recipient in the usual course of its operations that relate to the 
organization's compliance with this section, ``Prostitution and Related 
Activities.''
    All primary grantees receiving U.S. Government funds in connection 
with this document must certify compliance prior to actual receipt of 
such funds in a written statement referencing this document (e.g., 
``[Recipient's name] certifies compliance with the section, 
Prostitution and Related Activities. '') addressed to the agency's 
grants officer. Such certifications are prerequisites to the payment of 
any U.S. Government funds in connection with this document.
    Recipients' compliance with this section, ``Prostitution and 
Related Activities,'' is an express term and condition of receiving 
U.S. government funds in connection with this document, and any 
violation of it shall be grounds for unilateral termination by HHS of 
the agreement with HHS in connection with this document prior to the 
end of its term. The recipient shall refund to HHS the entire amount 
furnished in connection with this document in the event it is 
determined by HHS that the recipient has not complied with this 
section, ``Prostitution and Related Activities.''
    Funds may be used for:
    1. HIV counseling and testing within the program district(s) 
including required training, test kit purchase, simple laboratory 
refurbishment, vehicles and logistical support to testing teams, 
additional staffing and other related commodities and expenses.
    2. Evaluation and management of the activities.
    Awards will not allow reimbursement of pre-award costs. Guidance 
for completing your budget can be found on the CDC Web site, at the 
following Internet address: http://www.cdc.gov/od/pgo/funding/budgetguide.htm.

IV.6. Other Submission Requirements

    Application Submission Address: Submit your application by mail or 
express delivery service to: Technical Information Management-PA 04228, 
CDC Procurement and Grants Office, 2920 Brandywine Road, Atlanta, GA

[[Page 45334]]

30341. Applications may not be submitted electronically at this time.

V. Application Review Information

V.1. Criteria

    You are required to provide measures of effectiveness that will 
demonstrate the accomplishment of the various identified objectives of 
the cooperative agreement. Measures of effectiveness must relate to the 
performance goals stated in the ``Purpose'' section of this 
announcement. Measures must be objective and quantitative, and must 
measure the intended outcome. These measures of effectiveness must be 
submitted with the application and will be an element of evaluation.
    Your application will be evaluated against the following criteria:
    1. Understanding the issues, principles and systems requirements 
involved in delivering community and home-based VCT which provides 
access to the whole population of a district in the context of Uganda 
(25 points): Does the applicant demonstrate an understanding of the 
ethical, clinical, social, managerial and other practical issues 
involved in delivering comprehensive VCT in a cost effective and 
sensitive manner in the setting of a Ugandan district?
    2. Ability to carry out the proposal (25 points): Does the 
applicant demonstrate the capability to achieve the purpose of this 
proposal?
    3. Work Plan (25 points): Does the applicant describe activities, 
which are realistic, achievable, time-framed and appropriate to 
complete this program?
    4. Personnel (15 points): Are the personnel, including 
qualifications, training, availability, and experience adequate to 
carry out the proposed activities?
    5. Administrative and Accounting Plan (10 points): Is there a plan 
to prepare reports, monitoring and audit expenditures under this 
agreement, manage the resources of the program and produce, collect and 
analyze performance data?
    6. Budget (not scored): Is the budget for conducting the activity 
itemized and well-justified and consistent with stated activities and 
planned program activities?
    7. Human Subjects (not scored, but evaluated): Does the application 
adequately address the requirements of Title 45 CFR Part 46 for the 
protection of human subjects?

V.2. Review and Selection Process

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

V.3. Anticipated Announcement and Award Dates

    September 1, 2004.

VI. Award Administration Information

VI.1. Award Notices

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

VI.2. Administrative and National Policy Requirements

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

 AR-1 Human Subjects Requirements
 AR-10 Smoke-Free Workplace Requirements

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

VI.3. Reporting Requirements:

    You must provide CDC with an original, plus two hard copies of the 
following reports:
    1. Semi-annual progress reports, no less than 30 days after the end 
of the reporting period.
    2. Interim progress report, no less than 90 days before the end of 
the budget period. 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.
    f. Measures and Effectiveness.
    3. Financial status report, no more than 90 days after the end of 
the budget period.
    4. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    These reports must be mailed to the Grants Management or Contract 
Specialist listed in the ``Agency Contacts'' section of this 
announcement.

VII. Agency Contacts

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

    Dated: July 23, 2004.
William P. Nichols,
Acting Director, Procurement and Grants Office, Centers for Disease 
Control and Prevention.
[FR Doc. 04-17280 Filed 7-28-04; 8:45 am]
BILLING CODE 4163-18-P