[Federal Register Volume 73, Number 133 (Thursday, July 10, 2008)]
[Notices]
[Pages 39708-39712]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-15773]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Division of Nursing, Office of Public Health Nursing

    Funding Opportunity Number: HHS-2008-IHS-PHN-0001.
    Announcement Type: New.
    Catalog of Federal Domestic Assistance Number(s): 93.933.
    Key Dates:
    Application Deadline Date: August 4, 2008.
    Review Date: August 15, 2008.
    Award Announcement: August 22, 2008.
    Earliest Anticipated Start Date: August 29, 2008.

I. Funding Opportunity Description

    The Indian Health Service (IHS) Division of Nursing, Office of 
Public Health Nursing (PHN) announces a new competitive grant 
application for community based model of PHN case management services. 
This program is authorized under the Snyder Act, 25 U.S.C. 13; Section 
301(a), Public Health Service Act, as amended; and the Indian Health 
Care Improvement Act (IHCIA) 25 U.S.C. 1652. This program is described 
at 93.933 in the Catalog of Federal Domestic Assistance (CFDA).
    The purpose of the program is to improve health outcomes of high 
risk patients through a community case management model that utilizes 
the PHN as case manager. Research indicates nursing case management is 
a cost effective way to maximize health outcomes. The PHN Model of 
community based case management utilizes roles and functions of PHN 
services of assessment, planning, coordinating services, communication 
and monitoring. The goals and outcomes of the PHN Case Management model 
are early detection, diagnosis, treatment and evaluation that will 
improve health outcomes in a cost effective manner. This model utilizes 
all prevention components of primary, secondary and tertiary prevention 
in the home with patient and family. The community based case 
management model addresses the scope of practice of PHN working with 
individuals and families in a population-based practice.
    Health disparities are greater for American Indian/Alaska Native 
(AI/AN) communities than the general United States population. Infant 
mortality is greater in the AI/AN population than United States in 
general, suicide rates are greater, unintentional injuries are greater, 
and chronic disease is increasing. This project will focus on a PHN 
community based case management model. The project will be conducted in 
a phased approach, using the nursing process--assessment, planning, 
implementation, and evaluation.
    First Phase: Assessment--Conduct a comprehensive community 
assessment. The Senior Nurse Consultant will recommend a community 
assessment tool and provide appropriate training to the grantees in the 
Fall of 2008. Include, if available, pertinent data from the various 
community assessments and local health status data of the community in 
the community assessment.
    In addition, obtain input from key stake-holders such as, community 
members and healthcare administration and community health groups to 
determine the health care priorities. Develop plans for project 
sustainability.
    The PHN case management model will develop case management services 
addressing the priority health issues identified from the community 
assessment. The PHN case management program will establish policies and 
procedures, best practice (BP) for services, and mechanisms for 
tracking outcomes using the recommended PHN community based case 
management tool to improve the health care status.
    Second Phase: Planning--After the community assessment is completed 
and priorities for Public Health Nursing case management services are 
determined, planning the case management model project will begin. 
Obtain additional staff training needed

[[Page 39709]]

for the community based case management model and additional training 
needed such as evidence based practice, motivational interviewing, and 
any other training that would be applicable to the health issues 
addressed in the case management model. Plan specific case management 
services such as admission criteria, caseload size, policies and 
procedures, and an evaluation plan to include data tracking for 
outcomes generated and feedback to key stakeholders. Develop program 
guidelines. Obtain approval from healthcare administration. Develop 
patient education materials and community education materials for the 
program.
    Third Phase: Implementation--Case management program includes 
admission criteria, caseload size, and at risk population to receive 
this service with appropriate care standards. Patient caseload 
established. Monitor progress and make adjustments as needed. Track 
patient data outcomes. Continue to plan ongoing sustainability of 
program after award period ends.
    Fourth Phase: Patient Satisfaction Surveys--Data evaluation 
obtained from key stakeholders. Evaluate program services from 
population served and obtain satisfaction surveys. Evaluate and revise 
if needed, review policy and procedures and education materials. Report 
back to key stake-holders progress of the project.
    Each site will share program material with IHS Headquarters PHN 
program. This will be shared IHS-wide for replication of the project 
across IHS with credit given to the organization that developed the 
material. Poster presentation or oral presentation will be given at the 
National Combined Councils or IHS annual national nursing meeting.
    The Senior Nurse Consultant for PHN will make one or two site 
visits to each site.
    The program established must be sustainable after completion of the 
project.

II. Award Information

    Type of Awards: Grant.
    Estimated Funds Available: The total amount identified for fiscal 
year (FY) 2008 is $1,200,000. The awards are for 48 months in duration 
and the average award is $150,000 per year. Continuation awards under 
this announcement are subject to the availability of funds and 
satisfactory performance.
    Anticipated Number of Awards: A total of eight awards will be made 
under this Program Announcement. One award will be made to an urban 
program and seven awards to Tribes and/or Tribal programs.
    Project Period: 4 years (48 months).
    Award Amount: $150,000 per year.

III. Eligibility Information

    1. Eligible applicants, the AI/AN must be one of the following 
(please specify in the application which category applies to each 
applicant):
    A. A Federally-recognized Indian Tribe, or
    B. A Non-Profit Urban Indian Organization as defined by the IHCIA, 
25 U.S.C. 1603(f), or
    C. A Non-Profit Tribal organization as defined by the IHCIA, 25 
U.S.C. 1603(e).
    2. Supporting Documentation to Determine Eligibility:
    A. Tribal Resolution--If the applicant is an Indian Tribe or Tribal 
organization, a resolution from the Tribal government of all Tribes to 
be served supporting the project must accompany the application 
submission. Applications by Tribal organizations will not require 
resolutions if the current Tribal resolutions under which they operate 
would encompass the proposed activities. In this instance, a copy of 
the current resolution must accompany the application. The list of 
Tribes to be served by the project in the proposal must match the set 
of appended resolutions. If a resolution from an appropriate 
representative of each Tribe to be served is not submitted, the 
application will be considered incomplete and will not be considered 
for review. No separate mailings of documents will be accepted for the 
proposal; all documents, Tribal resolutions, etc., must accompany the 
submission as one complete proposal.
    B. Non-Profit applicants must submit proof of non-profit status. A 
current IRS tax exemption certificate or a copy of 501(c)3 form is 
required proof that must accompany all applications.
    3. Cost Sharing or Matching--The PHN will not require matching 
funds or cost sharing.
    4. Other Requirements
     If the application budget exceeds $150,000 per year, the 
application will not be considered for review.
     Each application must be accompanied by a Tribal 
Resolution or a 501(c)3. If applicant is unable to obtain an approved 
Tribal resolution by the application deadline, a letter explaining the 
steps taken to achieve one, and any barriers confronted should be 
explained. Urban centers should include a letter from their Board of 
Directors.

IV. Application and Submission Information

    1. Applicant package HHS-2008-IHS-PHN-0001 may be found at http://www.grants.gov Web site. Please use CFDA number HHS-2008-IHS-PHN-0001 
to search for the grant opportunity. Information regarding the 
electronic application process may be directed to Grants.gov Help Desk; 
1-800-518-4726. If the applicant is unable to resolve issues, applicant 
should contact Michelle Bulls at 301-443-6290.
    The entire application package and downloadable application 
instructions are available at http://www.grants.gov.
    2. Content and Form of Application Submission:
     Be single spaced.
     Be typewritten.
     Have consecutively numbered pages.
     Use black type not smaller than 12 characters per one 
inch.
     Contain a narrative that does not exceed 15 typed pages 
that includes the other submission requirements below. The 15 page 
narrative does not include the work plan, standard forms, Tribal 
resolutions, table of contents, budget, budget justifications, 
narratives, and/or other appendix items.
    Public Policy Requirements: All Federal-wide public policies apply 
to IHS grants with exception of the discrimination public policy.
    3. Submission Dates and Times: Applications must be submitted 
electronically through Grants.gov by August 4, 2008, 6 p.m. Eastern 
Standard Time (EST). If technical challenges arise and the applicant is 
unable to successfully complete the electronic application process, the 
applicant should contact Grants Policy Staff (GPS) at 301-443-6290 at 
least fifteen days prior to the application deadline and describe the 
difficulties that your organization continues to experience. The 
grantee must obtain prior approval, in writing (e-mails are 
acceptable), allowing the paper submission. If submission of a paper 
application is requested and approved, the original and two copies may 
be sent to: Norma Jean Dunne, Division of Grants Operations (DGO), 801 
Thompson Avenue, TMP 360, Rockville, MD 20852 by August 4, 2008 6:00 
p.m. EST. Applications not submitted through Grants.gov or submitted in 
hard copy without an approved waiver will be returned to the applicant 
without review or consideration. Late applications will not be accepted 
for processing, it will be returned to the applicant without further 
consideration.
    4. Intergovernmental Review: Executive Order 12372 requiring

[[Page 39710]]

intergovernmental review is not applicable to this program.
    5. Funding Restrictions:
     Pre-award costs are allowable pending prior approval from 
the awarding agency. However, in accordance with 45 CFR part 74, all 
pre-award costs are incurred at the recipient's risk. The awarding 
office is under no obligation to reimburse such costs if for any reason 
the applicant does not receive an award or if the award to the 
recipient is less than anticipated.
     The available funds are inclusive of direct and 
appropriate indirect costs.
     Only one grant will be awarded per eligible applicant.
     IHS will not acknowledge receipt of applications.
    6. Other Submission Requirements: If the applicant is unable to 
submit via Grants.gov and obtains a waiver from the standard 
application requirements please use the following forms: SF-424, 424A, 
424B, and certification forms, as appropriate. One original and two 
copies must be submitted to: Attn: Norma Jean Dunne; Division of Grants 
Operations; 801 Thompson Avenue, TMP 360, Rockville, MD 20852. 
Applications are due on August 4, 2008 prior to 6 p.m. EST.
    Electronic Submission--the preferred method for receipt of 
applications is electronic submission through Grants.gov. However, 
should any technical challenges arise regarding the submission, please 
contact Grants.gov Customer Support at 1-800-518-4726 or 
[email protected]. The Contact Center hours of operation are Monday-
Friday from 7 a.m. to 9 p.m. EST. The applicant must seek assistance at 
least fifteen days prior to the application deadline. Applicants that 
do not adhere to the timelines for Central Contractor Registry (CCR) 
and/or Grants.gov registration and/or requesting timely assistance with 
technical issues will not be a candidate for paper applications.
    To submit an application electronically, please use the http://
www.Grants.gov Web site and select ``Apply for Grants'' link on the 
home page. Download a copy of the application package, on the 
Grants.gov Web site, complete it offline and then upload and submit the 
application via the Grants.gov site.
    You may not e-mail an electronic copy of a grant application to 
IHS.
    Please be reminded of the following:
     Under the new IHS application submission requirements, 
paper applications are not the preferred method. However, if you have 
technical problems submitting your application on-line, please contact 
directly Grants.gov Customer Support at: http://www.grants.gov/CustomerSupport.
     Upon contacting grants.gov, obtain a tracking number as 
proof of contact. The tracking number is helpful if there are technical 
issues that cannot be resolved and a waiver request from GPS must be 
obtained.
     If it is determined that a formal waiver is necessary, the 
applicant must submit a request, in writing (e-mails are acceptable), 
to [email protected] that includes a justification for the need to 
deviate from the standard electronic submission process. Upon receipt 
of approval, a hard-copy application package must be downloaded by the 
applicant from Grants.gov, completed, and sent directly to the Division 
of Grants Operations, 801 Thompson Avenue, TMP 360, Rockville, MD 20852 
by August 4, 2008 6 p.m. EST.
     Upon entering the Grants.gov Web site, there is 
information available that outlines the requirements to the applicant 
regarding electronic submission of an application through Grants.gov, 
as well as the hours of operation. We strongly encourage all applicants 
not to wait until the deadline date to begin the application process 
through Grants.gov as the registration process for CCR and Grants.gov 
could take up to fifteen working days.
     To use Grants.gov, you, as the applicant, must have a Data 
Universal Numbering System (DUNS) number and register in the CCR. You 
should allow a minimum of ten working days to complete CCR 
registration. See below on how to apply.
     You must submit all documents electronically, including 
all information typically included on the SF-424 and all necessary 
assurances and certifications.
     Please use the optional attachment feature in Grants.gov 
to attach additional documentation that may be requested by IHS.
     Your application must comply with any page limitation 
requirements described in the program announcement.
     After you electronically submit your application, you will 
receive an automatic acknowledgment from Grants.gov that contains a 
Grants.gov tracking number. The IHS DGO will download your application 
from Grants.gov and provide necessary copies to the cognizant program 
office. The DGO will not notify applicants that the application has 
been received.
     You may access the electronic application for this program 
on http://www.Grants.gov.
     You may search for the downloadable application package by 
either the CFDA 93.933 number or the Funding Opportunity Number (FON) 
HHS-2008-IHS-PHN-0001.
     The applicant must provide FON HHS-2008-IHS-PHN-0001.
    E-mail applications will not be accepted under this announcement.

DUNS Number

    Applicants are required to have a DUNS number to apply for a grant 
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 http://www.dunandbradstreet.com or call 1-866-705-
5711. Interested parties may wish to obtain their DUNS number by phone 
to expedite the process.
    Applications submitted electronically must also be registered with 
the CCR. A DUNS number is required before CCR registration can be 
completed. Many organizations may already have a DUNS number. Please 
use the number listed above to investigate whether or not your 
organization has a DUNS number.
    Registration with the CCR is free of charge. Applicants may 
register by calling 1-888-227-2423. Please review and complete the CCR 
Registration Worksheet located on http://www.grants.gov/CCRRegister.
    More detailed information regarding these registration processes 
can be found at http://www.grants.gov.

V. Application Review Information

1. Criteria

    The instructions for preparing the application narrative also 
constitute the evaluation criteria for reviewing and scoring the 
application. Weights assigned to each section are noted in parentheses. 
The narrative should include four years of activities. The narrative 
section should be written in a manner that is clear to outside 
reviewers unfamiliar with prior related activities of the applicant. It 
should be well organized, succinct, and contain all information 
necessary for reviewers to understand the project fully.
    a. Format--maximum of 15 pages (5 Points).
     Be single spaced.
     Be typewritten.
     Have consecutively numbered pages.
     Use black type not smaller than 12 characters per one 
inch.
     The narrative should not exceed 15 typed pages that 
include the other submission requirements below. The 15 page narrative 
does not include the work plan, standard forms, Tribal

[[Page 39711]]

resolutions (if necessary), or organization's letter of support, proof 
of Non-Profit status, table of contents, budget, budget justifications, 
narratives, and/or other appendix items.
    b. Background/Problem Statement (5 Points).
     Provide demographic information, prevalence rates of 
disease, and baseline health data to substantiate the proposal.
     Describe how data collection will support the stated 
project objectives and how it will support the project evaluation in 
order to determine the impact of the project. Address how the proposed 
project will result in health improvements.
     Name of facility, location, type of site (Direct Care, 
Tribal or urban).
     Contact person and phone number, address, e-mail address, 
and fax number.
    c. Goals and Objectives (25 Points).
     Establish two to three measurable objectives within a plan 
that will provide significant outcome. Goals/Objectives should be 
specific with a realistic time line.
    d. Methodology/Activities (20 Points).
     Describe the activities that will be implemented in a work 
plan to meet the objectives. The work plan should be directly related 
to the objectives.
     Describe how you will monitor the objectives (chart 
reviews, survey, etc.).
     Describe any collaborative efforts with programs outside 
of PHN.
    e. Budget (15 Points).
     Discuss all expected expenses for each project year, one 
through four.
     Provide a justification of the funds for each project 
year, one through four.
     Provide a succinct description of specific roles and 
activities of each person involved in the proposed project and their 
ability to perform in that capacity.
    f. Evaluation (30 Points).
    Describe the methods for evaluating the project activities. Each 
proposed project objective should have an evaluation component and the 
evaluation activities should appear on the work plan. At a minimum, 
projects should describe plans to collect or summarize evaluation 
information about all project activities. Please address the following 
for each of the proposed objectives:
     Describe the community assessment tool that will be 
reviewed and what data will be selected to evaluate the success of the 
objective(s)?
     How the data will be collected to assess the program's 
objective(s) (e.g., methods used such as, but not limited to, community 
focus groups, surveys, interviews, or other data collection 
activities)?
     When the data will be collected and the data analysis 
completed?
     The extent to which there are specific data sets, data 
bases or registries already in place to measure/monitor meeting 
objective.
     Who will collect the data and any cost of the evaluation 
(whether internal or external)?
     Where and to whom the data will be presented, key stake 
holders?
     Address anticipated obstacles to the success of the 
proposal such as underlying causes and the nature of their influence on 
accomplishing the objectives.
     Describe how the community assessment will be evaluated.
     Describe the process that will be used to follow-up on the 
PHN Case Management Project findings/conclusions.
    When the applicant is approved for funding, the award recipient 
must comply with the proposal or provisions may result in withholding 
of support of other eligible projects.

2. Review and Selection Process

    a. The review committee will review each proposal according to this 
program announcement and undertake an in-depth evaluation based on the 
reviewer's findings, recommendations, scoring, and approval or 
disapproval. The final selection determination will be made by the PHN 
Nurse Consultant.
    b. All applications meeting the proposal requirements will be 
scored.
    c. The final score will be ranked by totaling the numerical scores 
and dividing by the number of reviewers which will be read into the 
record.
    d. Each reviewer will use the score sheet when evaluating 
proposals, a signature and date will complete the evaluation record 
which will be returned to the committee chairperson.
    e. The review committee may provide differing scores to the 
chairperson for discussion, resolution, and committee consensus.
    f. The review will be conducted in accordance with the IHS 
Objective Review Guidelines. The applications will be evaluated and 
rated on the basis of the evaluation criteria.
    g. An Executive Summary will be used to provide advice to the 
program officials in making award decisions and comments to applicants.
     The review committee chairperson will compile an Executive 
Summary of the review, findings, recommendation, and comments of the 
project type, and proposal scores.
     The reviewer's written evaluation will be used by the 
selecting official.

3. Anticipated Announcement and Award Dates

    Anticipated Announcement date is August 22, 2008 and Award Date is 
August 29, 2008.

VI. Award Administration Information

1. Award Notices

    The Notice of Award (NoA) will be initiated by the DGO and will be 
mailed via postal mail to each entity that is approved for funding 
under this announcement. The NoA will be signed by the Grants 
Management Officer, and this is the authorizing document for which 
funds are dispersed to the approved entities. The NoA will serve as the 
official notification of the grant award and will reflect the amount of 
Federal funds awarded, the purpose of the grant, the terms and 
conditions of the award, the effective date of the award, and the 
budget and project periods. The NoA is the legally binding document. 
Applicants who are approved but unfunded or disapproved based on their 
Objective Review score will receive a copy of the Executive Summary 
which identifies the weaknesses and strengths of the application 
submitted.



    2. Administrative Requirements.
    Grants are administrated in accordance with the following 
documents:
     This Program Announcement.
     Administrative Requirements: 45 CFR Part 92, ``Uniform 
Administrative Requirements for Grants and Cooperative Agreements to 
State, Local and Tribal Governments,'' or 45 CFR Part 74, ``Uniform 
Administrative Requirements for Awards to Institutions of Higher 
Education, Hospitals, Other Non-Profit Organizations, and Commercial 
Organizations.''
     Grants Policy Guidance: HHS Grants Policy Statement, 
January 2007.
     Cost Principles: OMB Circular A-87, ``State, Local, and 
Indian'' (Title 2 Part 225).
     Cost Principles: OMB Circular A-122, ``Non-Profit 
Organizations'' (Title 2 Part 230).
     Audit Requirements: OMB Circular A-133, ``Audits of 
States, Local Governments, and Non-profit Organizations.''
    3. Indirect Costs: This section applies to all grant recipients 
that request reimbursement of indirect costs in their grant 
application. In accordance with HHS Grants Policy Statement, Part II-
27, IHS requires applicants to have a current indirect cost rate 
agreement in place prior to award. The rate agreement

[[Page 39712]]

must be prepared in accordance with the applicable cost principles and 
guidance as provided by the cognizant agency or office. A current rate 
means the rate covering the applicable activities and the award budget 
period. If the current rate is not on file with the DGO at the time of 
award, the indirect cost portion of the budget will be restricted and 
not available to the recipient until the current rate is provided to 
the DGO.
    Generally, indirect costs rates for IHS grantees are negotiated 
with the Division of Cost Allocation http://rates.psc.gov/ and the 
Department of Interior, National Business Center at http://www.nbc.gov/acquisition/ics/icshome.html Web site. If your organization has 
questions regarding the indirect cost policy, please contact the DGO at 
(301) 443-5204.

4. Reporting

    A. Progress Report. Program progress reports are required semi-
annually. These reports will include a brief comparison of actual 
accomplishments to the goals established for the period, or, if 
applicable, provide sound justification for the lack of progress, and 
other pertinent information as required. A final report must be 
submitted within 90 days of expiration of the budget/project period.
    B. Financial Status Report. Semi-annual financial status reports 
must be submitted within 30 days of the end of the half year. Final 
financial status reports are due within 90 days of expiration of the 
budget/project period. Standard Form 269 (long form) will be used for 
financial reporting.
    Grantees are responsible and accountable for accurate reporting of 
the Progress Reports and Financial Status Reports which are generally 
due semi-annually and the final reports, Financial Status Report (SF-
269) and Program Progress Report are due 90 days after each budget 
period. The grantee must verify how the value was derived and submit 
reports according to the terms and conditions of the award.
    Failure to submit required reports within the time allowed may 
result in suspension or termination of an active grant, withholding of 
additional awards for the project, or other enforcement actions such as 
withholding of payments or converting to the reimbursement method of 
payment. Continued failure to submit required reports may result in one 
or both of the following: (1) The imposition of special award 
provisions; and (2) the non-funding or non-award of other eligible 
projects or activities. This applies whether the delinquency is 
attributable to the failure of the grantee organization or the 
individual responsible for preparation of the reports.
    5. Telecommunication for the hearing impaired is available at: TTY 
(301) 443-6394.

VII. Agency Contacts

    For program-related information regarding the community based model 
of PHN case management services: Cheryl Peterson, R.N., Project 
Official, Indian Health Service, 801 Thompson Avenue, Suite 329, 
Rockville, Maryland 20852, (301) 443-1840, [email protected].
    For general information regarding this announcement: Ms. Orie 
Platero, Office Clinical and Preventive Services, Indian Health 
Service, 801 Thompson Avenue, Suite 326, Rockville, Maryland 20852, 
(301) 443-2522, Fax: (301) 594-6213.
    For specific grant-related and business management information: Ms. 
Norma Jean Dunne, Division of Grant Operations, Indian Health Service, 
801 Thompson Avenue, TMP 360-79, Rockville, Maryland 20852, (301) 443-
5204, Fax: (301) 443-9602.

VIII. Other Information

    The Department of Health and Human Services (HHS) is committed to 
achieving the health promotion and disease prevention objectives of 
Healthy People 2010, a HHS-led activity for setting priority areas. 
This project will aid the accomplishment of Healthy People 2010 Focus 
Area 1--Access. Potential applicants may obtain a printed copy of 
Healthy People 2010, (Summary Report No, 017-001-00549-5) or CD-ROM, 
Stock No. 017-001-00549-5, through the Superintendent of Documents, 
Government Printing Office, P.O. Box 371954, Pittsburgh, PA 15250-7945, 
(202) 512-1800. You may also access this information at the following 
Web site: http://www.healthypeople.gov/Publications.
    The IHS is focusing efforts on three Health Initiatives that, 
linked together, have the potential to achieve positive improvements in 
the health of AI/AN people. These three initiatives are Health 
Promotion/Disease Prevention, Management of Chronic Disease, and 
Behavioral Health. Further information is available at the Health 
Initiatives Web site: http://www.ihs.gov/NonMedicalPrograms/DirInitiatives/index.cfm.

    Dated: June 27, 2008.
Robert G. McSwain,
Director, Indian Health Service.
[FR Doc. E8-15773 Filed 7-9-08; 8:45 am]
BILLING CODE 4165-16-P