[Federal Register Volume 86, Number 144 (Friday, July 30, 2021)]
[Notices]
[Pages 41044-41051]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-16283]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Community Health Aide Program: Tribal Planning & Implementation
Announcement Type: New.
Funding Announcement Number: HHS-2021-IHS-TPI-0001.
Assistance Listing (Catalog of Federal Domestic Assistance or CFDA)
Number: 93.382.
Key Dates
Application Deadline Date: September 1, 2021.
Earliest Anticipated Start Date: September 30, 2021.
I. Funding Opportunity Description
Statutory Authority
The Indian Health Service (IHS) is accepting applications for
grants for the Community Health Aide Program (CHAP) Tribal Planning and
Implementation (TPI) program. The CHAP is authorized under the Snyder
Act, 25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and the Indian
Health Care Improvement Act, 25 U.S.C. 16161. This grant program is
described in the Assistance Listings located at https://beta.sam.gov
(formerly known as Catalog of Federal Domestic Assistance) under
93.382.
Background
The national CHAP will provide a network of health aides trained to
support licensed health professionals while providing direct health
care,
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health promotion, and disease prevention services. These providers will
work within a referral relationship under the supervision of licensed
clinical providers that includes clinics, service units, and hospitals.
The program will increase access to direct health services, including
inpatient and outpatient visits.
The Alaska CHAP has become a model for efficient and high quality
health care delivery in rural Alaska, providing approximately 300,000
patient encounters per year and responding to emergencies 24 hours a
day, seven days a week. Specialized providers in dental and behavioral
health were later introduced to respond to the needs of patients and
address the health disparities in oral health and mental health among
American Indians and Alaska Natives.
The national CHAP is a workforce model that includes three
different provider types that act as extenders of their licensed
clinical supervisor. The national CHAP currently includes a behavioral
health aide, community health aide, and dental health aide. Each of the
health aide categories operate in a tiered level practice system. The
national CHAP model provides an opportunity for increased access to
care through the extension of primary care, dental, and behavioral
health clinicians.
In 2010, under the permanent reauthorization of the Indian Health
Care Improvement Act (IHCIA), Congress provided the Secretary of the
U.S. Department of Health and Human Services, acting through the IHS,
the authority to expand the Alaska CHAP program. In 2016, the IHS
initiated Tribal Consultation on expanding the CHAP to the contiguous
48 states. In 2018, the IHS formed the CHAP Tribal Advisory Group (TAG)
and began developing the program. In 2020, the IHS announced the
national CHAP policy, which formally created the national CHAP.
Purpose
The purpose of the TPI program is to support the planning and
implementation for Tribes and Tribal Organizations (T/TO) positioned to
begin operating a CHAP or support a growing CHAP in the contiguous 48
states. The grant program is designed to support the regional
flexibility required for T/TO to implement a CHAP unique to the needs
of their individual communities across the country through the
identification of feasibility factors. The focus of the program is to:
1. Develop clinical supervisor support for primary care, behavioral
health, and dental health clinicians providing both direct and indirect
supervision of prospective health aides;
2. Identify area and community-specific health care needs of
patients that can be addressed by the health aides;
3. Identify and develop a technology infrastructure plan for the
mobility and success of health aides in anticipation of providing
services;
4. Develop a training plan to include partners across the T/TO's
geographic region to enhance the training opportunities available to
prospective health aides to include continuing education and clinical
practice;
5. Identify best practices for integrating a CHAP workforce into an
existing Tribal health system;
6. Address social determinants of health that impact the
recruitment and retention of prospective health aides; and
7. Identify the total cost of full implementation of a CHAP within
an existing Tribal health system.
II. Award Information
Funding Instrument--Grant
Estimated Funds Available
The total funding identified for fiscal year (FY) 2021 is
approximately $1,500,000. Individual award amounts are anticipated to
be between $450,000 and $500,000. The funding available for competing
awards issued under this announcement is subject to the availability of
appropriations and budgetary priorities of the Agency. The IHS is under
no obligation to make awards that are selected for funding under this
announcement.
Anticipated Number of Awards
Approximately three awards will be issued under this program
announcement. The IHS intends to award no more than one grant per IHS
area.
Period of Performance
The period of performance is two years.
III. Eligibility Information
1. Eligibility
To be eligible for this new FY 2021 funding opportunity, an
applicant must be one of the following, as defined under 25 U.S.C.
1603:
A federally recognized Indian Tribe as defined by 25
U.S.C. 1603(14). The term ``Indian Tribe'' means any Indian Tribe,
band, nation, or other organized group or community, including any
Alaska Native village or group, or regional or village corporation, as
defined in or established pursuant to the Alaska Native Claims
Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is
recognized as eligible for the special programs and services provided
by the United States to Indians because of their status as Indians.
A Tribal organization as defined by 25 U.S.C. 1603(26).
The term ``Tribal organization'' has the meaning given the term in
section 4 of the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 5304): ``Tribal organization'' means the recognized
governing body of any Indian Tribe; any legally established
organization of Indians which is controlled, sanctioned, or chartered
by such governing body or which is democratically elected by the adult
members of the Indian community to be served by such organization and
which includes the maximum participation of Indians in all phases of
its activities: provided that, in any case where a contract is let or
grant made to an organization to perform services benefiting more than
one Indian Tribe, the approval of each such Indian Tribe shall be a
prerequisite to the letting or making of such contract or grant.
Applicant shall submit letters of support and/or Tribal Resolutions
from the Tribes to be served.
An applicant may not apply to both this opportunity, TPI, and the
CHAP Tribal Assessment and Planning (TAP) opportunity (number HHS-2021-
IHS-TAP-0001).
An organization currently carrying out a CHAP in the United States,
in accordance with 25 U.S.C. 1616l through an Indian Self-Determination
and Education Assistance Act (ISDEAA) agreement, is eligible to apply,
but may not utilize the funds to carry out a CHAP.
The Program Office will notify any applicants deemed ineligible.
Note: Please refer to Section IV.2 (Application and Submission
Information/Subsection 2, Content and Form of Application Submission)
for additional proof of applicant status documents required, such as
Tribal Resolutions, proof of nonprofit status, etc.
2. Cost Sharing or Matching
The IHS does not require matching funds or cost sharing for grants
or cooperative agreements.
3. Other Requirements
Applications with budget requests that exceed the highest dollar
amount outlined under Section II Award Information, Estimated Funds
Available, or exceed the Period of Performance outlined under Section
II Award Information, Period of Performance, will
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be considered not responsive and will not be reviewed. The Division of
Grants Management (DGM) will notify the applicant.
Additional Required Documentation
Tribal Resolution
The DGM must receive an official, signed Tribal Resolution prior to
issuing a Notice of Award (NoA) to any applicant selected for funding.
An Indian Tribe or Tribal organization that is proposing a project
affecting another Indian Tribe must include resolutions from all
affected Tribes to be served. However, if an official, signed Tribal
Resolution cannot be submitted with the application prior to the
application deadline date, a draft Tribal Resolution must be submitted
with the application by the deadline date in order for the application
to be considered complete and eligible for review. The draft Tribal
Resolution is not in lieu of the required signed resolution but is
acceptable until a signed resolution is received. If an application
without a signed Tribal Resolution is selected for funding, the
applicant will be contacted by the Grants Management Specialist (GMS)
listed in this funding announcement and given 90 days to submit an
official, signed Tribal Resolution to the GMS. If the signed Tribal
Resolution is not received within 90 days, the award will be forfeited.
Tribes organized with a governing structure other than a Tribal
council may submit an equivalent document commensurate with their
governing organization.
Proof of Nonprofit Status
Organizations claiming nonprofit status must submit a current copy
of the 501(c)(3) Certificate with the application.
IV. Application and Submission Information
1. Obtaining Application Materials
The application package and detailed instructions for this
announcement are hosted on https://www.Grants.gov.
Please direct questions regarding the application process to Mr.
Paul Gettys at (301) 443-2114 or (301) 443-5204.
2. Content and Form Application Submission
Mandatory documents for all applicants include:
Abstract (one page) summarizing the project.
Application forms:
1. SF-424, Application for Federal Assistance.
2. SF-424A, Budget Information--Non-Construction Programs.
3. SF-424B, Assurances--Non-Construction Programs.
Project Narrative (not to exceed 15 pages). See Section
IV.2.A Project Narrative for instructions.
1. Background information on the organization.
2. Proposed scope of work, objectives, and activities that provide
a description of what the applicant plans to accomplish.
Budget Justification and Narrative (not to exceed 5
pages). See Section IV.2.B Budget Narrative for instructions.
One-page Timeframe Chart.
Tribal Resolution(s).
Letters of Support from organization's Board of Directors
(if applicable).
501(c)(3) Certificate.
Biographical sketches for all Key Personnel.
Contractor/Consultant resumes or qualifications and scope
of work.
Disclosure of Lobbying Activities (SF-LLL), if applicant
conducts reportable lobbying.
Certification Regarding Lobbying (GG-Lobbying Form).
Copy of current Negotiated Indirect Cost rate (IDC)
agreement (required in order to receive IDC).
Organizational Chart (optional).
Documentation of current Office of Management and Budget
(OMB) Financial Audit (if applicable).
Acceptable forms of documentation include:
1. Email confirmation from Federal Audit Clearinghouse (FAC) that
audits were submitted; or
2. Face sheets from audit reports. Applicants can find these on the
FAC website at https://harvester.census.gov/facdissem/Main.aspx.
Public Policy Requirements
All Federal public policies apply to IHS grants and cooperative
agreements. Pursuant to 45 CFR 80.3(d), an individual shall not be
deemed subjected to discrimination by reason of their exclusion from
benefits limited by Federal law to individuals eligible for benefits
and services from the IHS. See https://www.hhs.gov/grants/grants/grants-policies-regulations/index.html.
Requirements for Project and Budget Narratives
A. Project Narrative
This narrative should be a separate document that is no more than
15 pages and must: (1) Have consecutively numbered pages; (2) use black
font 12 points or larger; (3) be single-spaced; and (4) be formatted to
fit standard letter paper (8\1/2\ x 11 inches).
Be sure to succinctly answer all questions listed under the
evaluation criteria (refer to Section V.1, Evaluation Criteria) and
place all responses and required information in the correct section
noted below or they will not be considered or scored. If the narrative
exceeds the page limit, the application will be considered not
responsive and will not be reviewed. The 15-page limit for the
narrative does not include the work plan, standard forms, Tribal
Resolutions, budget, budget justifications, narratives, and/or other
items.
There are three parts to the narrative: Part 1--Program
Information; Part 2--Program Plan; and Part 3--Program Evaluation. See
below for additional details about what must be included in the
narrative.
The page limits below are for each narrative and budget submitted.
Part 1: Program Information (Limit--4 pages)
Section 1: Community Profile
Describe the demographics of the community including, but not
limited to, geography, languages, age, and socioeconomic status. The
community profile should include data specific to the community that
would benefit from the implementation of CHAP.
Section 2: Health & Infrastructure Needs
Describe the community's current health disparities related to
primary, behavioral, and oral health care. The needs section should
provide facts and evidence related to infrastructure barriers (e.g.,
recruitment, retention, and access to facilities).
Section 3: Organizational Capacity
Describe the T/TO's current health program activities, how long it
has been operating, and what programs or services are currently being
provided. Describe in full the organization's infrastructure and its
ability to assess the feasibility of implementing a CHAP and
identifying significant barriers that could prohibit the
implementation.
Part 2: Program Plan (Limit--6 pages)
Section 1: Program Plan
Describe in full the direction the T/TO plans to take in the CHAP
TPI. The program plan should identify the plan to address Tribal
infrastructure needs specific to:
Clinical supervisor support and clinical operations.
Enhanced scope of work to address community and region
specific needs.
Training infrastructure (including continuing education).
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Technology infrastructure.
System integration.
Support to prospective health aides that address social
determinants of health.
Section 2: Program Activities
Describe in full how the applicant will develop a robust clinical
support system for the clinical supervision of providers. The
activities should also include how the applicant will correlate the
community health needs to additional requirements to be included into
the scope of work of health aides, a detailed plan of how to adjust the
clinical operations to incorporate a CHAP, and the training plan to
include continuing education for prospective health aides. Describe the
resources the applicant will provide for health aides once the CHAP is
operating, including technology investments to aide in mobility of
providers and auxiliary supports to address critical social
determinants of health. The program plan activities should also include
how the applicant plans to calculate the full implementation.
Section 3: Staffing Plan
Describe key staff tasked with carrying out the program activities
in Section 2. Applicants are highly encouraged to partner with other
key stakeholders within the T/TO's region for a robust understanding of
the needs and implications of implementing a CHAP into their respective
communities.
Section 4: Timeline
Describe a timeline not to exceed two years for the completion of
the program plan, activities, and evaluation plan. Provide a timeline
chart depicting a realistic timeline that details all major activities,
milestones, and applicable staffing plans. The timeline should include
the projected progress report due at the midpoint of the project
period. The timeline chart should not exceed one page.
Part 3: Program Evaluation (Limit--5 pages)
Section 1: Evaluation Plan
Please identify and describe significant program activities and
achievements associated with the delivery of quality health services.
Provide a plan to provide a comparison of the actual accomplishments to
the goals established for the project period, or if applicable, provide
justification for the lack of progress. The evaluation plan should
address major categories related to (See Sample Logic Model in Related
Documents in Grants.gov):
Clinical supervision support.
Enhanced scope of practice.
Training infrastructure (including continuing education).
Technology needs.
Integration best practices.
Auxiliary supports for prospective health aides working
within the system.
Calculating total implementation cost.
B. Budget Narrative (Limit--5 pages)
Provide a budget narrative that explains the amounts requested for
each line item of the budget from the SF-424A (Budget Information for
Non-Construction Programs). The budget narrative should specifically
describe how each item will support the achievement of proposed
objectives. Be very careful about showing how each item in the
``Other'' category is justified. For subsequent budget years (see
Multi-Year Project Requirements in Section V.1. Application Review
Information, Evaluation Criteria), the narrative should highlight the
changes from year 1 or clearly indicate that there are no substantive
budget changes during the period of performance. Do NOT use the budget
narrative to expand the project narrative.
3. Submission Dates and Times
Applications must be submitted through Grants.gov by 11:59 p.m.
Eastern Time on the Application Deadline Date. Any application received
after the application deadline will not be accepted for review.
Grants.gov will notify the applicant via email if the application is
rejected.
If technical challenges arise and assistance is required with the
application process, contact Grants.gov Customer Support (see contact
information at https://www.Grants.gov). If problems persist, contact
Mr. Paul Gettys ([email protected]), Acting Director, DGM, by
telephone at (301) 443-2114 or (301) 443-5204. Please be sure to
contact Mr. Gettys at least ten days prior to the application deadline.
Please do not contact the DGM until you have received a Grants.gov
tracking number. In the event you are not able to obtain a tracking
number, call the DGM as soon as possible.
The IHS will not acknowledge receipt of applications.
4. Intergovernmental Review
Executive Order 12372 requiring intergovernmental review is not
applicable to this program.
5. Funding Restrictions
Pre-award costs are allowable up to 90 days before the
start date of the award provided the costs are otherwise allowable if
awarded. Pre-award costs are incurred at the risk of the applicant.
The available funds are inclusive of direct and indirect
costs.
Only one grant may be awarded per applicant.
6. Electronic Submission Requirements
All applications must be submitted via Grants.gov. Please use the
https://www.Grants.gov website to submit an application. Find the
application by selecting the ``Search Grants'' link on the homepage.
Follow the instructions for submitting an application under the Package
tab. No other method of application submission is acceptable.
If the applicant cannot submit an application through Grants.gov, a
waiver must be requested. Prior approval must be requested and obtained
from Mr. Paul Gettys, Acting Director, DGM. A written waiver request
must be sent to [email protected] with a copy to
[email protected]. The waiver request must be documented in writing
(emails are acceptable) before submitting an application by some other
method, and include clear justification for the need to deviate from
the required application submission process.
Once the waiver request has been approved, the applicant will
receive a confirmation of approval email containing submission
instructions. A copy of the written approval must be included with the
application that is submitted to the DGM. Applications that are
submitted without a copy of the signed waiver from the Acting Director
of the DGM will not be reviewed. The Grants Management Officer of the
DGM will notify the applicant via email of this decision. Applications
submitted under waiver must be received by the DGM no later than 5:00
p.m., Eastern Time, on the Application Deadline Date. Late applications
will not be accepted for processing. Applicants that do not register
for both the System for Award Management (SAM) and Grants.gov and/or
fail to request timely assistance with technical issues will not be
considered for a waiver to submit an application via alternative
method.
Please be aware of the following:
Please search for the application package in https://www.Grants.gov by entering the Assistance Listing (CFDA) number or the
Funding Opportunity Number. Both numbers are located in the header of
this announcement.
If you experience technical challenges while submitting
your application, please contact Grants.gov Customer Support (see
contact information at https://www.Grants.gov).
[[Page 41048]]
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 from the agency must be
obtained.
Applicants are strongly encouraged not to wait until the
deadline date to begin the application process through Grants.gov as
the registration process for SAM and Grants.gov could take up to 20
working days.
Please follow the instructions on Grants.gov to include
additional documentation that may be requested by this funding
announcement.
Applicants must comply with any page limits described in
this funding announcement.
After submitting the application, the applicant will
receive an automatic acknowledgment from Grants.gov that contains a
Grants.gov tracking number. The IHS will not notify the applicant that
the application has been received.
Dun and Bradstreet (D&B) Data Universal Numbering System (DUNS)
Applicants and grantee organizations are required to obtain a DUNS
number and maintain an active registration in the SAM database. The
DUNS number is a unique 9-digit identification number provided by D&B
that uniquely identifies each entity. The DUNS number is site specific;
therefore, each distinct performance site may be assigned a DUNS
number. Obtaining a DUNS number is easy, and there is no charge. To
obtain a DUNS number, please access the request service through https://fedgov.dnb.com/webform or call (866) 705-5711.
The Federal Funding Accountability and Transparency Act of 2006, as
amended (``Transparency Act''), requires all HHS recipients to report
information on sub-awards. Accordingly, all IHS grantees must notify
potential first-tier sub-recipients that no entity may receive a first-
tier sub-award unless the entity has provided its DUNS number to the
prime grantee organization. This requirement ensures the use of a
universal identifier to enhance the quality of information available to
the public pursuant to the Transparency Act.
System for Award Management (SAM)
Organizations that are not registered with SAM must have a DUNS
number first, then access the SAM online registration through the SAM
home page at https://sam.gov (U.S. organizations will also need to
provide an Employer Identification Number from the Internal Revenue
Service that may take an additional 2-5 weeks to become active). Please
see SAM.gov for details on the registration process and timeline.
Registration with the SAM is free of charge but can take several weeks
to process. Applicants may register online at https://sam.gov.
Additional information on implementing the Transparency Act,
including the specific requirements for DUNS and SAM, are available on
the DGM Grants Management, Policy Topics web page: https://www.ihs.gov/dgm/policytopics/.
V. Application Review Information
Possible points assigned to each section are noted in parentheses.
The 15-page project narrative should include only the first year of
activities; information for multi-year projects should be included as a
separate document. See ``Multi-year Project Requirements'' at the end
of this section for more information. 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 fully
understand the project. Points will be assigned to each evaluation
criteria adding up to a total of 100 possible points. Points are
assigned as follows:
1. Evaluation Criteria
A. Introduction and Need for Assistance (10 points)
Identify the proposed project and plans to fully implement a CHAP
within their community. The needs should clearly identify the existing
health system and how the CHAP will be integrated to meet the health
needs of the community in the fields of behavioral, oral, and primary
health care.
B. Project Objective(s), Work Plan, and Approach (30 points)
The work plan should be comprised of two key parts: Program
Information and Program Plan. Provide information related to three key
sections: Community profile; health and infrastructure; and
organizational capacity. The Program Information part should
demonstrate a robust community profile that highlights the existing
health system, demographic data of community members and user
population, and a detailed description of the T/TO carrying out the
proposed activity. An acceptable Program Plan expecting to receive full
points should include details of the applicants plan to address the
program objective. The Program Plan should address, at a minimum, key
activities related to clinical supervisor support, scope of work,
technology infrastructure, training infrastructure, integration best
practices, and auxiliary support to health aides that address social
determinants.
C. Program Evaluation (30 points)
The program evaluation should be comprised of two key sections:
Evaluation plan and outcome report. The evaluation plan should address
major categories related to:
Clinical supervisor support;
enhanced scope of work;
technology infrastructure;
training infrastructure;
integration best practices;
auxiliary support; and
full implementation costs (See Sample Logic Model in
Related Documents in Grants.gov).
The evaluation plan should identify how the T/TO plans to fully
integrate CHAP. The evaluation should include total implementation
costs based on the implementation plan and program plan identified,
including any significant implementation barriers. List measurable and
attainable goals with explicit timelines that detail expectation of
findings. The Outcome Report should describe, in full, the findings of
the program plan, evaluation, and determination on stage of readiness
for implementation. The outcome report should organize the findings
into at least five of the seven categories:
1. Clinical Supervisor Support.
2. Scope of Work.
3. Technology Infrastructure.
4. Training Infrastructure.
5. Integration Planning.
6. Auxiliary Support.
7. Implementation Cost.
Applicants are encouraged to identify additional categories above
the seven aforementioned and may choose to develop subcategories that
best fit the program plan.
D. Organizational Capabilities, Key Personnel, and Qualifications (10
points)
Provide a detailed biographical sketch of each member of key
personnel assigned to carry out the objectives of the program plan. The
sketches should detail the qualifications and expertise of identified
staff.
E. Categorical Budget and Budget Justification (20 points)
Provide a detailed budget of each expenditure directly related to
the identified program activities.
Multi-Year Project Requirements
Applications must include a brief project narrative and budget (one
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additional page per year) addressing the developmental plans for each
additional year of the project. This attachment will not count as part
of the project narrative or the budget narrative.
Additional documents can be uploaded as Other Attachments in
Grants.gov
Work plan, logic model, and/or timeline for proposed
objectives.
Position descriptions for key staff.
Resumes of key staff that reflect current duties.
Consultant or contractor proposed scope of work and letter
of commitment (if applicable).
Current Indirect Cost Rate Agreement.
Organizational chart.
Map of area identifying project location(s).
Additional documents to support narrative (i.e., data
tables, key news articles, etc.).
2. Review and Selection
Each application will be prescreened for eligibility and
completeness, as outlined in the funding announcement. Applications
that meet the eligibility criteria shall be reviewed for merit by the
Objective Review Committee (ORC) based on evaluation criteria.
Incomplete applications and applications that are not responsive to the
administrative thresholds (budget limit, project period limit) will not
be referred to the ORC and will not be funded. The applicant will be
notified of this determination.
Applicants must address all program requirements and provide all
required documentation.
3. Notifications of Disposition
All applicants will receive an Executive Summary Statement from the
IHS Office of Clinical and Preventive Services within 30 days of the
conclusion of the ORC outlining the strengths and weaknesses of their
application. The summary statement will be sent to the Authorizing
Official identified on the face page (SF-424) of the application.
A. Award Notices for Funded Applications
The NoA is the authorizing document for which funds are dispersed
to the approved entities and reflects 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/project period.
Each entity approved for funding must have a user account in
GrantSolutions in order to retrieve the NoA. Please see the Agency
Contacts list in Section VII for the systems contact information.
B. Approved But Unfunded Applications
Approved applications not funded due to lack of available funds
will be held for one year. If funding becomes available during the
course of the year, the application may be reconsidered.
Note: Any correspondence other than the official NoA executed by an
IHS grants management official announcing to the project director that
an award has been made to their organization is not an authorization to
implement their program on behalf of the IHS.
VI. Award Administration Information
1. Administrative Requirements
Awards issued under this announcement are subject to, and are
administered in accordance with, the following regulations and
policies:
A. The Criteria as Outlined in This Program Announcement
B. Administrative Regulations for Grants
Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for HHS Awards currently in effect or implemented
during the period of award, other Department regulations and policies
in effect at the time of award, and applicable statutory provisions. At
the time of publication, this includes 45 CFR part 75, at https://www.govinfo.gov/content/pkg/CFR-2020-title45-vol1/pdf/CFR-2020-title45-vol1-part75.pdf.
Please review all HHS regulatory provisions for
Termination at 45 CFR 75.372, at https://www.ecfr.gov/cgi-bin/retrieveECFR?gp&;SID=2970eec67399fab1413ede53d7895d99&mc=true&
;n=pt45.1.75&r=PART&ty=HTML&se45.1.75_1372#se45.1.75_1372.
C. Grants Policy
HHS Grants Policy Statement, Revised 01/07, at http://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
D. Cost Principles
Uniform Administrative Requirements for HHS Awards, ``Cost
Principles,'' at 45 CFR part 75, subpart E.
E. Audit Requirements
Uniform Administrative Requirements for HHS Awards,
``Audit Requirements,'' at 45 CFR part 75, subpart F.
F. As of August 13, 2020, 2 CFR 200 has been updated to include a
prohibition on certain telecommunications and video surveillance
services or equipment. This prohibition is described in 2 CFR 200.216.
This will also be described in the terms and conditions of every IHS
grant and cooperative agreement awarded on or after August 13, 2020.
2. Indirect Costs
This section applies to all recipients that request reimbursement
of indirect costs (IDC) in their application budget. In accordance with
HHS Grants Policy Statement, Part II-27, IHS requires applicants to
obtain a current IDC rate agreement and submit it to the DGM prior to
the DGM issuing an award. The rate agreement must be prepared in
accordance with the applicable cost principles and guidance as provided
by the cognizant agency or office. A current rate covers the applicable
grant activities under the current award's budget period. If the
current rate agreement is not on file with the DGM at the time of
award, the IDC portion of the budget will be restricted. The
restrictions remain in place until the current rate agreement is
provided to the DGM.
Per 45 CFR 75.414(f) Indirect (F&A) costs, ``any non-Federal entity
[i.e., applicant] that has never received a negotiated indirect cost
rate, . . . may elect to charge a de minimis rate of 10 percent of
modified total direct costs (MTDC) which may be used indefinitely. As
described in Section 75.403, costs must be consistently charged as
either indirect or direct costs, but may not be double charged or
inconsistently charged as both. If chosen, this methodology once
elected must be used consistently for all Federal awards until such
time as the non-Federal entity chooses to negotiate for a rate, which
the non-Federal entity may apply to do at any time.''
Electing to charge a de minimis rate of 10 percent only applies to
applicants that have never received an approved negotiated indirect
cost rate from HHS or another cognizant federal agency. Applicants
awaiting approval of their indirect cost proposal may request the 10
percent de minimis rate. When the applicant chooses this method, costs
included in the indirect cost pool must not be charged as direct costs
to the grant.
Available funds are inclusive of direct and appropriate indirect
costs. Approved indirect funds are awarded as part of the award amount,
and no additional funds will be provided.
Generally, IDC rates for IHS grantees are negotiated with the
Division of Cost Allocation (DCA) at https://rates.psc.gov/ or the
Department of the Interior (Interior Business Center) at
[[Page 41050]]
https://ibc.doi.gov/ICS/tribal. For questions regarding the indirect
cost policy, please call the Grants Management Specialist listed under
``Agency Contacts'' or the main DGM office at (301) 443-5204.
3. Reporting Requirements
The grantee must submit required reports consistent with the
applicable deadlines. 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 the imposition of special award
provisions and/or the non-funding or non-award of other eligible
projects or activities. This requirement applies whether the
delinquency is attributable to the failure of the awardee organization
or the individual responsible for preparation of the reports. Per DGM
policy, all reports must be submitted electronically by attaching them
as a ``Grant Note'' in GrantSolutions. Personnel responsible for
submitting reports will be required to obtain a login and password for
GrantSolutions. Please see the Agency Contacts list in Section VII for
the systems contact information.
The reporting requirements for this program are noted below.
A. Progress Reports
Program progress reports are required semi-annually. The progress
reports are due within 30 days after the budget period ends (specific
dates will be listed in the NoA Terms and Conditions). These reports
must include a brief comparison of actual accomplishments to the goals
established for the period, a summary of progress to date 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 period of performance.
B. Financial Reports
Federal Cash Transaction Reports are due 30 days after the close of
every calendar quarter to the Payment Management Services at https://pms.psc.gov. Failure to submit timely reports may result in adverse
award actions blocking access to funds.
Federal Financial Reports are due 30 days after the end of each
budget period, and a final report is due 90 days after the end of the
Period of Performance. Grantees are responsible and accountable for
accurate information being reported on all required reports: The
Progress Reports, the Federal Cash Transaction Report, and the Federal
Financial Report.
C. Data Collection and Reporting
At the conclusion of the program period, the outcome report should
detail how the T/TO plans to completely integrate CHAP into their
Tribal health system and list major barriers that could potentially
impact full integration. The Outcome Report should describe, in full,
the findings of the program plan and evaluation, and plans for
implementation. The outcome report should organize the findings of the
key categories:
1. Clinical Supervisor Support.
2. Scope of Practice.
3. Technology Infrastructure.
4. Training Plan.
5. System Integration.
6. Auxiliary Support to Address Social Determinants.
Based on the findings and measurable outcomes of the categories,
the applicant should explicitly identify the implementation plan and
projected cost associated with full implementation.
D. Federal Sub-Award Reporting System (FSRS)
This award may be subject to the Transparency Act sub-award and
executive compensation reporting requirements of 2 CFR part 170.
The Transparency Act requires the OMB to establish a single
searchable database, accessible to the public, with information on
financial assistance awards made by Federal agencies. The Transparency
Act also includes a requirement for recipients of Federal grants to
report information about first-tier sub-awards and executive
compensation under Federal assistance awards. IHS has implemented a
Term of Award into all IHS Standard Terms and Conditions, NoAs, and
funding announcements regarding the FSRS reporting requirement. This
IHS Term of Award is applicable to all IHS grant and cooperative
agreements issued on or after October 1, 2010, with a $25,000 sub-award
obligation threshold met for any specific reporting period. For the
full IHS award term implementing this requirement and additional award
applicability information, visit the DGM Grants Management website at
https://www.ihs.gov/dgm/policytopics/.
E. Compliance With Executive Order 13166 Implementation of Services
Accessibility Provisions for All Grant Application Packages and Funding
Opportunity Announcements
Recipients of Federal financial assistance (FFA) from HHS must
administer their programs in compliance with Federal civil rights laws
that prohibit discrimination on the basis of race, color, national
origin, disability, age, and, in some circumstances, religion,
conscience, and sex. This includes ensuring programs are accessible to
persons with limited English proficiency. The HHS Office for Civil
Rights provides guidance on complying with civil rights laws enforced
by HHS. Please see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and http://www.hhs.gov/ocr/civilrights/understanding/section1557/index.html.
Recipients of FFA must ensure that their programs are
accessible to persons with limited English proficiency. HHS provides
guidance to recipients of FFA on meeting their legal obligation to take
reasonable steps to provide meaningful access to their programs by
persons with limited English proficiency. Please see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/index.html and https://www.lep.gov. For further guidance on providing culturally and
linguistically appropriate services, recipients should review the
National Standards for Culturally and Linguistically Appropriate
Services in Health and Health Care at https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53.
Recipients of FFA also have specific legal obligations for
serving qualified individuals with disabilities. Please see http://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
HHS funded health and education programs must be
administered in an environment free of sexual harassment. Please see
https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html; https://www2.ed.gov/about/offices/list/ocr/docs/shguide.html; and https://www.eeoc.gov/eeoc/publications/fs-sex.cfm.
Recipients of FFA must also administer their programs in
compliance with applicable Federal religious nondiscrimination laws and
applicable Federal conscience protection and associated anti-
discrimination laws. Collectively, these laws prohibit exclusion,
adverse treatment, coercion, or other discrimination against persons or
[[Page 41051]]
entities on the basis of their consciences, religious beliefs, or moral
convictions. Please see https://www.hhs.gov/conscience/conscience-protections/index.html and https://www.hhs.gov/conscience/religious-freedom/index.html.
Please contact the HHS Office for Civil Rights for more information
about obligations and prohibitions under Federal civil rights laws at
https://www.hhs.gov/ocr/about-us/contact-us/index.html or call 1-800-
368-1019 or TDD 1-800-537-7697.
F. Federal Awardee Performance and Integrity Information System
(FAPIIS)
The IHS is required to review and consider any information about
the applicant that is in the Federal Awardee Performance and Integrity
Information System (FAPIIS) at https://www.fapiis.gov before making any
award in excess of the simplified acquisition threshold (currently
$250,000) over the period of performance. An applicant may review and
comment on any information about itself that a Federal awarding agency
previously entered. The IHS will consider any comments by the
applicant, in addition to other information in FAPIIS, in making a
judgment about the applicant's integrity, business ethics, and record
of performance under Federal awards when completing the review of risk
posed by applicants as described in 45 CFR 75.205.
As required by 45 CFR part 75, appendix XII, of the Uniform
Guidance, non-Federal entities (NFEs) are required to disclose in
FAPIIS any information about criminal, civil, and administrative
proceedings, and/or affirm that there is no new information to provide.
This applies to NFEs that receive Federal awards (currently active
grants, cooperative agreements, and procurement contracts) greater than
$10,000,000 for any period of time during the period of performance of
an award/project.
Mandatory Disclosure Requirements
As required by 2 CFR part 200 of the Uniform Guidance and the HHS
implementing regulations at 45 CFR part 75, the IHS must require an NFE
or an applicant for a Federal award to disclose, in a timely manner, in
writing to the IHS or pass-through entity all violations of Federal
criminal law involving fraud, bribery, or gratuity violations
potentially affecting the Federal award. Submission is required for all
applicants and recipients, in writing, to the IHS and to the HHS Office
of Inspector General, all information related to violations of Federal
criminal law involving fraud, bribery, or gratuity violations
potentially affecting the Federal award. 45 CFR 75.113.
Disclosures must be sent in writing to: U.S. Department of Health
and Human Services, Indian Health Service, Division of Grants
Management, ATTN: Paul Gettys, Acting Director, 5600 Fishers Lane, Mail
Stop: 09E70, Rockville, MD 20857, (Include ``Mandatory Grant
Disclosures'' in subject line), Office: (301) 443-5204, Fax: (301) 594-
0899, Email: [email protected].
And
U.S. Department of Health and Human Services, Office of Inspector
General, ATTN: Mandatory Grant Disclosures, Intake Coordinator, 330
Independence Avenue SW, Cohen Building, Room 5527, Washington, DC
20201, URL: https://oig.hhs.gov/fraud/report-fraud/, (Include
``Mandatory Grant Disclosures'' in subject line), Fax: (202) 205-0604
(Include ``Mandatory Grant Disclosures'' in subject line) or, Email:
[email protected].
Failure to make required disclosures can result in any of the
remedies described in 45 CFR 75.371 Remedies for noncompliance,
including suspension or debarment (see 2 CFR parts 180 & 376).
VII. Agency Contacts
1. Questions on the programmatic issues may be directed to: Minette
C. Galindo, Public Health Advisor, Indian Health Service, Office of
Clinical and Preventive Services, 5600 Fishers Lane, Mail Stop: 08N34A,
Rockville, MD 20857, Phone: (301) 443-4644, Fax: (301) 594-6213, Email:
[email protected].
2. Questions on grants management and fiscal matters may be
directed to: Donald Gooding, Grants Management Specialist, Indian
Health Service, Division of Grants Management, 5600 Fishers Lane, Mail
Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-2298, Email:
[email protected].
3. Questions on systems matters may be directed to: Paul Gettys,
Acting Director, Indian Health Service, Division of Grants Management,
5600 Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, Phone: (301)
443-2114; or the DGM main line (301) 443-5204, email:
[email protected].
VIII. Other Information
The Public Health Service strongly encourages all grant,
cooperative agreement, and contract recipients to provide a smoke-free
workplace and promote the non-use of all tobacco products. In addition,
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in
certain facilities (or in some cases, any portion of the facility) in
which regular or routine education, library, day care, health care, or
early childhood development services are provided to children. This is
consistent with the HHS mission to protect and advance the physical and
mental health of the American people.
Elizabeth A. Fowler,
Acting Director, Indian Health Service.
[FR Doc. 2021-16283 Filed 7-29-21; 8:45 am]
BILLING CODE 4165-16-P