[Federal Register Volume 86, Number 215 (Wednesday, November 10, 2021)]
[Pages 62546-62554]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-24577]



Indian Health Service

4-in-1 Grant Program

    Announcement Type: New and Competing Continuation.
    Funding Announcement Number: HHS-2022-IHS-UIHP2-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.193.

Key Dates

    Application Deadline Date: February 8, 2022.
    Earliest Anticipated Start Date: March 25, 2022.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for 
grants for the 4-in-1 Grant Program. This program is authorized under 
the Snyder Act, 25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and 
Title V of the Indian Health Care Improvement Act (IHCIA), at 25 U.S.C. 
1653(c)-(e) (authorizing grants for Health Promotion and Disease 
Prevention (HP/DP) services, Immunization services, and Mental Health 
services), and 1660a (authorizing grants for Alcohol and Substance 
Abuse related services). This program is described in the Assistance 
Listings located at https://sam.gov/content/home (formerly known as 
Catalog of Federal Domestic Assistance) under 93.193.


    In the late 1960s, Urban Indian community leaders began advocating 
at the local, state, and Federal levels to address the unmet health 
care needs of Urban Indians, and requested health care services and 
programs. These efforts resulted in an increase of preventative, 
medical, and behavioral health services, but there was growing 
recognition of challenges preventing Urban Indians in seeking health 
care services. To address these barriers, advocacy focused on the 
development of culturally-appropriate activities that were unique to 
the social, cultural, and spiritual needs of American Indians and 
Alaska Natives residing in urban settings. Programs developed at that 
time were staffed by volunteers in storefront settings, with limited 
budgets, offering primary care and outreach and referral services.
    In response to efforts of the Urban Indian community leaders, 
Congress appropriated funds in 1966 through the IHS for a pilot urban 
clinic in Rapid City, South Dakota. In 1973, Congress appropriated 
funds to study unmet Urban Indian health needs in Minneapolis, 
Minnesota. The findings of this study documented cultural, economic, 
and access barriers to health care and led to congressional 
appropriations to support emerging Urban Indian clinics in several 
Bureau of Indian Affairs relocation cities, e.g., Seattle, San 
Francisco, Tulsa, and Dallas. In 1976, Congress passed the IHCIA 
establishing the Urban Indian health program, and reauthorized the 
IHCIA in 2010 to improve the health and well-being of all American 
Indians and Alaska Natives, including Urban Indians. The development of 
programs for Urban Indians residing in urban areas include HP/DP 
services, immunization services, alcohol and substance abuse related 
services, and mental health services, hereafter referred to as the ``4-
in-1 health program.''


    The purpose of this program is to ensure the highest possible 
health status for Urban Indians. Funding will be used to support the 4-
in-1 health program objectives. These programs are integral components 
of the IHS health care delivery system. Funds from this effort will 
ensure that comprehensive, culturally acceptable personal and public 
health services are available and accessible to Urban Indians.

Required, Optional, and Allowable Activities

    Each grantee shall provide health care services under this award 
only to eligible Urban Indians living within the urban center in which 
the Urban Indian Organization (UIO) is situated. An ``Urban Indian'' 
eligible for services, as codified at 25 U.S.C. 1603(13), (27), and 
(28), includes any individual who:
    1. Resides in an urban center, which is any community that has a 
sufficient Urban Indian population with unmet health needs to warrant 
assistance under the IHCIA, as determined by the Secretary, Health and 
Human Services (HHS), and who meets one or more of the following 
    a. Irrespective of whether he or she lives on or near a 
reservation, is a member of a Tribe, band, or other organized group of 
Indians, including:
    i. Those Tribes, bands, or groups terminated since 1940, and
    ii. those recognized now or in the future by the state in which 
they reside, or
    b. Is a descendant, in the first or second degree, of any such 
member described in 1.a.; or

[[Page 62547]]

    c. Is an Eskimo, or Aleut, or other Alaska Native; or
    d. Is a California Indian; \1\ or

    \1\ Consistent with 25 U.S.C. 1603(3), (13), (28), and 1679, 
eligibility of California Indians may be demonstrated by 
documentation that the individual:
    1. Is a descendant of an Indian who was residing in the State of 
California on June 1, 1852;
    2. Holds trust interests in public domain, national forest, or 
Indian reservation allotments; or
    3. Is listed on the plans for distribution of assets of 
California Rancherias and reservations under the Act of August 18, 
1958 (72 Stat. 619), or is the descendant of such an individual.

    e. Is considered by the Secretary of the Department of the Interior 
to be an Indian for any purpose; or
    f. Is determined to be an Indian under regulations pertaining to 
Urban Indian health that are promulgated by the Secretary, HHS.
    Each grantee is responsible for taking reasonable steps to confirm 
that the individual is eligible for IHS services as an Urban Indian.

II. Award Information

Funding Instrument--Grant

Estimated Funds Available
    The total funding identified for fiscal year (FY) 2022 is 
approximately $8.5 million. Individual award amounts for the first 
budget year are anticipated to be between $160,000 and $650,000. New 
applicants may apply for funding up to $200,000; current 4-in-1 
grantees may apply for funding up to the amount approved in the last 
noncompeting award and must demonstrate that they have complied with 
previous terms and conditions of their award. The funding available for 
competing and subsequent continuation 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 33 awards will be issued under this program 
Period of Performance
    The period of performance is for 5 years.

III. Eligibility Information

1. Eligibility

     To be eligible for this FY 2022 funding opportunity, an 
applicant must be an Urban Indian organization, as defined by 25 U.S.C. 
1603(29), that is currently administering a contract or receiving a 
grant pursuant to 25 U.S.C. 1653. The term ``Urban Indian 
organization'' means a nonprofit corporate body situated in an urban 
center, governed by an Urban Indian controlled board of directors, and 
providing for the maximum participation of all interested Indian groups 
and individuals, which body is capable of legally cooperating with 
other public and private entities for the purpose of performing the 
activities described in 25 U.S.C. 1653(a). Applicants must provide 
proof of nonprofit status with the application, e.g., 501(c)(3).
    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 proof of nonprofit status.

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, are considered not 
responsive and will not be reviewed. The Division of Grants Management 
(DGM) will notify the applicant.
Additional Required Documentation
Documentation of Support
    The UIO must submit a letter of support from their organization's 
board of directors.
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 available at 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. Each of 
the 4-in-1 health program areas (HP/DP, immunization, alcohol and 
substance abuse, and mental health), should be addressed in a separate 
Grant Program Function or Activity row/column of the SF-424A.
    3. SF-424B, Assurances--Non-Construction Programs.
     Project Narrative (not to exceed 20 pages). See Section 
IV.2.A, Project Narrative for instructions.
    1. Background information on the organization.
    2. Statement of need, proposed scope of work, required objectives, 
and activities that provide a description of what the applicant plans 
to accomplish and evaluation and performance measurement plan.
     Budget Justification and Narrative (not to exceed five 
pages). See Section IV.2.B, Budget Narrative for instructions.
     Letter of Support from the UIO's Board of Directors.
     501(c)(3) Certificate.
     Biographical sketches for all Key Personnel (not to exceed 
one page each).
     Contractor/Consultant proposed scope of work and letter of 
commitment (not to exceed one page each, if applicable).
     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 or written information that shows 
where the 4-in-1 health program areas fit into the larger organization.
     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

[[Page 62548]]

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 
20 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 20-page limit for the 
narrative does not include the standard forms, budget, budget 
justification, narrative, and/or other items.
    There are three parts to the narrative: Part 1--Program 
Information; Part 2--Program Planning and Evaluation; and Part 3--
Organizational Capacity. See below for additional details about what 
must be included in the narrative.
Part 1: Program Information
Section 1: Needs
    The statement of need describes the history and urban center 
currently served by the applicant. The statement of need also provides 
the facts and evidence that support the need for each of the 4-in-1 
health program areas and establishes that the UIO understands the 
problems and can reasonably address them.
     Describe the current service gaps, including disconnection 
between available services and unmet needs of Urban Indians. This 
should include services at the UIO and in communities where Urban 
Indians reside.
     Describe the need for an enhanced infrastructure to 
increase the capacity to implement, sustain, and improve effective 
health care services offered to Urban Indians and any other service 
gaps and problems related to the need for infrastructure development 
within the UIO.
Part 2: Program Planning and Evaluation
Section 1: Program Plans
    State the purpose, goals, and objectives of your proposed projects. 
Clearly state how proposed activities address the needs detailed in the 
statement of need. Describe fully and clearly plans to meet each of the 
4-in-1 health program areas of this funding announcement. Each 
objective should be addressed with a corresponding time frame. Provide 
a work plan for year 1 budget period that details expected key 
activities, accomplishments, and includes responsible staff for each of 
the 4-in-1 health program areas.
Section 2: Program Evaluation
    This section of the narrative should describe efforts to collect 
and report project data that will support and demonstrate grant 
activities for each of the 4-in-1 health program areas. Grantees will 
be required to participate in a national evaluation of the 4-in-1 grant 
program. Grantees will also be required to collect and report data 
pertaining to activities, processes, and outcomes. Data collection 
activities should capture and document actions conducted throughout 
awarded years, including activities that will contribute to relevant 
project impact. This section should also describe the applicant's plan 
to evaluate program activities, including any practice-based and 
evidence-based prevention or treatment programs implemented. The 
evaluation plan should describe expected results and any identified 
metrics to support program effectiveness. Evaluation plans should 
incorporate questions related to outcomes and processes, including 
documentation of lessons learned.
     Describe in a brief narrative a plan to monitor activities 
under each of the 4-in-1 health program areas to demonstrate progress 
towards program outcomes and inform future program decisions over the 
5-year project period.
     Describe proposed evaluation methods, including 
performance measures and other data relevant to evaluation outcomes, 
including intended results (e.g., impact and outcomes). Include any 
partners who will assist in evaluation efforts if separate from the 
primary applicant.
Part 3: Organizational Capacity
    Section 1: This section should describe your organizational 
capacity for each of the 4-in-1 health program areas. Current staff and 
future positions for the four program components should also be 
     Identify qualified professionals who will implement and 
administer the proposed grant activities, including progress and 
financial reports.
     Identify a contact person to maintain open and consistent 
communication with the IHS program official on any programmatic 
barriers to meeting the requirements of the award.
     Describe the organization's current system and ability to 
develop partnerships with service providers and community programs, 
including families and support systems of Urban Indians.
     Describe potential project partners and community 
resources in the urban center.
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 document can include a 
more detailed spreadsheet than is provided by the SF-424A. Each 4-in-1 
health program area should have a separate budget. 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 the first year 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 
    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.

[[Page 62549]]

5. Funding Restrictions

     Pre-award costs are not allowable.
     The available funds are inclusive of direct and indirect 
     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: (1) Be documented in 
writing (emails are acceptable) before submitting an application by 
some other method; and (2) 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 
    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).
     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 
     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 
     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 at https://www.ihs.gov/dgm/policytopics/.

V. Application Review Information

    Possible points assigned to each section are noted in parentheses. 
The project narrative and budget 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 
project narrative 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. 
Attachments requested in the criteria do not count toward the page 
limit for the project narrative. 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

    Applications will be reviewed and scored according to the quality 
of responses to the required application components in Sections A-E 
outlined below. In developing the required sections of this 
application, use the instructions provided for each section, which have 
been tailored to this program. The application must use the five 
sections (Sections A-E) listed below in developing the narratives. The 
applicant must place the required information in the correct section or 
it will not be considered for review. The application will be scored 
according to how well the applicant addresses the requirements for each 
section listed below. The number of points after each section heading 
is the maximum number of points the Objective Review Committee (ORC) 
may assign to that section. Although scoring weights are not assigned 
to individual bullets, each bullet is assessed deriving the overall 
section score.
A. Introduction and Need for Assistance (25 Points)
    1. Identify the proposed urban center and provide demographic 

[[Page 62550]]

on the population(s) to receive services. Describe the stakeholders and 
resources in the urban center that can help implement activities for 
each of the 4-in-1 health program areas.
    2. Based on the information and/or data currently available, 
document the need to implement, sustain, and improve health care 
services offered to Urban Indians.
    3. Based on available data, describe the service gaps and other 
problems related to the needs of Urban Indians. Identify the source of 
the data. Documentation of need may come from a variety of qualitative 
and quantitative sources. Examples of data sources for the quantitative 
data that could be used are local epidemiologic data such as Tribal 
Epidemiology Centers or IHS Area Offices, state data from state needs 
assessments, and/or national data from the Substance Abuse and Mental 
Health Services Administration's (SAMHSA) National Survey on Drug Use 
and Health, or from the National Center for Health Statistics/Centers 
for Disease Control, and U.S. Census data (American Community Survey, 
etc.). This list is not exhaustive. Applicants may submit other valid 
data, as appropriate, for the applicant's programs.
B. Project Objective(s), Work Plan, and Approach (30 Points)
    1. Describe the purpose of the proposed project, including a clear 
statement of goals and objectives. The project narrative is required to 
address each of the 4-in-1 health program areas.
    a. HP/DP: Applicants are encouraged to use evidence-based and 
promising strategies that can be found at the IHS best practice 
database at https://www.ihs.gov/hpdp/, SAMHSA Evidence-based Practices 
Resource Center at https://www.samhsa.gov/resource-search/ebp, and the 
Guide to Community Preventive Services at https://www.thecommunityguide.org/about/about-community-guide. Applicants are 
encouraged to work collaboratively with their assigned Area HP/DP 
    b. Immunization: Applicants are encouraged to participate in the 
Vaccines for Children program (if applicable). Applicants are 
encouraged to research capability with state/regional immunization 
registry (where applicable). For sites using the IHS Resource and 
Patient Measurement System (RPMS), provide training sessions to 
providers and data entry clerks on the RPMS Immunization package. 
Establish a process for immunization data entry into RPMS (e.g., point 
of service or through standard data entry). Utilize the RPMS 
Immunization package to identify 3- to 27-month-old children whose 
immunization records are not up to date and that generate reminder/
recall letters. Applicants are encouraged to work collaboratively with 
their assigned Area Immunization Coordinator.
    c. Alcohol and Substance Abuse: Describe services to be provided, 
e.g., residential, detox, halfway house, counseling, outreach and 
referral, etc. Describe substance abuse prevention and education 
efforts to increase access to services, outreach, education, 
prevention, and treatment of substance abuse related issues. Applicants 
are encouraged to work collaboratively with their assigned Area 
Behavioral Health Consultant.
    d. Mental Health: Identify services to be provided, e.g., community 
outreach and referral, prevention, training sessions, evaluations, 
schools, domestic violence programs, child abuse programs, etc. 
Describe mental health prevention and education program efforts to 
increase access to services, outreach, referral, education, prevention, 
and treatment of mental health related issues. Applicants are 
encouraged to work collaboratively with their assigned Area Behavioral 
Health Consultant.
    2. Describe how project activities will increase the capacity of 
the UIO to improve access to and quality of care for Urban Indians.
    3. Describe anticipated barriers and how these barriers will be 
    4. Describe how the proposed project will address issues of 
diversity for Urban Indians, including race/ethnicity, gender, culture/
cultural identity, language, sexual orientation, disability, and 
    5. Describe how Urban Indians may receive services for the 4-in-1 
health program areas and how they will be involved in the planning and 
implementation of the grant.
    6. Describe how the efforts of the proposed project will be 
coordinated with any other related Federal grants, including the IHS, 
Centers for Disease Control and Prevention, SAMHSA, or Health Resources 
and Services Administration, etc. (if applicable).
    7. Provide a work plan for the first year budget period that 
details expected key activities, accomplishments, and includes 
responsible staff for each of the 4-in-1 health program areas.
C. Program Evaluation (20 Points)
    Describe plans to monitor activities under each of the 4-in-1 
health program areas, demonstrate progress towards program outcomes, 
and inform future program decisions over the 5 year project period. 
Applications should address the following points:
    1. Describe proposed data collection efforts (performance measures 
and associated data) and how you will use the data to answer evaluation 
questions. This should include data collection method, data source, 
data measurement tool, identified staff for data management, and data 
collection timeline.
    2. Identify key program partners and describe how they will 
participate in the implementation of the evaluation plan (e.g., Tribal 
Epidemiology Centers, universities, etc.).
    3. Describe data collection and evaluation of any proposed 
practice-based and/or evidence-based care programs implemented 
throughout awarded years.
    4. Describe how evaluation findings will be used at the applicant 
level. Discuss how data collected (e.g., performance measurement data) 
will be used and shared by the key program partners.
    5. Discuss any barriers or challenges expected for implementing the 
plan, collecting data (e.g., responding to performance measures), and 
reporting on evaluation results. Describe how these potential barriers 
would be overcome. In addition, applicants may also describe other 
measures to be developed or additional data sources and data collection 
methods that applicants will use.
D. Organizational Capabilities, Key Personnel, and Qualifications (15 
    1. Describe the management capability of the UIO and other 
participating organizations in administering similar projects.
    2. Identify staff to maintain open and consistent communication 
with the IHS program official on any financial or programmatic barriers 
to meeting the requirements of the award.
    3. Identify the department(s) and/or division(s) that will 
administer each of the 4-in-1 health program areas. Include a 
description of these department(s) and/or division(s), their functions, 
and their placement within the UIO and their direct link to management.
    4. Discuss the UIO's experience and capacity to provide culturally 
appropriate and competent services to the community and specific 
populations of focus.
    5. Describe the resources available for the proposed project (e.g., 
facilities, equipment, information technology systems, and financial 
management systems).

[[Page 62551]]

    6. Identify other organization(s) that will participate in the 
proposed project. Describe their roles and responsibilities and 
demonstrate their commitment to each of the 4-in-1 health program 
    7. Describe how project continuity will be maintained if there is a 
change in the operational environment (e.g., staff turnover, change in 
project leadership, etc.) to ensure project stability over the life of 
the grant.
    8. Provide a list of staff positions for the project and other key 
personnel, showing the role of each and their level of effort and 
qualifications for each of the 4-in-1 health program areas. Key 
personnel include the Chief Executive Officer or Executive Director, 
Chief Financial Officer, Medical Director, and Chief Information 
    9. Demonstrate successful project implementation for the level of 
effort budgeted for the project staff and other key staff.
    10. Include position descriptions (upload as Other Attachments) for 
all key personnel. Position descriptions should not exceed one page 
each. Reviewers will not consider information past one page.
    11. For individuals who are currently on staff, include a 
biographical sketch with their name (do not include personally 
identifiable information such as social security number or date and 
place of birth) for each individual that will be listed as the project 
staff and other key positions. Describe the experience of identified 
staff in each of the 4-in-1 health program areas. Upload each 
biographical sketch in the Other Attachments form in your Grants.gov 
application workspace. Biographical sketches should not exceed one page 
per staff member. Reviewers will not consider information past one 
page. Do not include any of the following:
    a. Personally Identifiable Information (social security number and 
date and place of birth);
    b. Resumes; or
    c. Curriculum Vitae.
E. Categorical Budget and Budget Justification (10 Points)
    1. Include a line item budget for each of the 4-in-1 health program 
areas for all expenditures identifying reasonable and allowable costs 
necessary to accomplish the goals and objectives as outlined in the 
project narrative for the first budget year only.
    2. Provide a categorized budget for each of the 4-in-1 health 
program areas.
    3. Applicants should ensure that the budget and budget narrative 
are aligned with the project narrative. The budget and budget narrative 
the applicant provides will be considered by reviewers in assessing the 
applicant's submission, along with the material in the project 
narrative. Questions to address include: What resources are needed to 
successfully carry out and manage the project? What other resources are 
available from the organization? Will new staff be recruited? Will 
outside consultants be required?
    4. For any outside consultants, include the total cost broken down 
by activity.
    5. If indirect costs are claimed, indicate and apply the current 
negotiated rate to the budget. Include a copy of the current negotiated 
IDC rate agreement in the Other Attachments form in the application 
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (1 
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. These can include:
     Work plan, logic model, and/or timeline for proposed 
     Position descriptions for key staff (not to exceed one 
page each).
     Biographical sketch of key staff that reflect current 
duties (not to exceed one page each).
     Consultant or contractor proposed scope of work and letter 
of commitment (not to exceed one page each) (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 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 Urban Indian Health Programs 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 Notice of Award (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 
B. Approved but Unfunded Applications
    Approved applications not funded due to lack of available funds 
will be held for 1 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 
    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/

[[Page 62552]]

    C. Grants Policy:
     HHS Grants Policy Statement, Revised January 2007, at 
    D. Cost Principles:
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' located at 45 CFR part 75 subpart E.
    E. Audit Requirements:
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' located at 45 CFR part 75 subpart F.
    F. As of August 13, 2020, 2 CFR 200 was 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, the 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 
(NFE) [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 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 NFE chooses to negotiate for a rate, which the NFE 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 at https://rates.psc.gov/ or the Department 
of the Interior (Interior Business Center) at 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 quarterly. The progress 
reports are due within 30 days after the reporting period ends 
(specific dates will be listed in the NoA Terms and Conditions). 
Grantees have the option to use the 4-in-1 Grant Reporting Template 
instead of developing their own format. The template is available at 
the 4-in-1 Grant web page at https://www.ihs.gov/urban/4-in-1-grant-program/.
    The quarterly Progress Report shall demonstrate actual goals and 
objectives were met against established target measures, a summation of 
the program approach, and report on integrated cultural interventions 
and implementation of practice-based and/or evidence-based approaches, 
including a concise summary narrative of the program's impact on the 
Urban Indian service population. If applicable, program changes for the 
next reporting period may be included.
    To comply with statutory requirements consistent with 25 U.S.C. 
1653(a), 1655, and 1657(a), the Progress Reporting Template includes a 
section for the grantee to report their unmet needs or the grantee may 
use their own format to report their unmet needs. This includes 
information gathered by the grantee to: (1) Identify gaps between unmet 
health needs of Urban Indians and the resources available to meet such 
needs; and (2) make recommendations to the Secretary and Federal, 
state, local, and other resource agencies on methods of improving 
health services to meet the needs of Urban Indians.
    The final end of year and 4th quarter 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 
reporting accurate information on all required reports: The Progress 
Reports, the Federal Cash Transaction Report, and the Federal Financial 
C. Data Collection and Reporting
1. Government Performance and Results Act Reporting (GPRA)
    The GPRA data period shall be the Federal fiscal year of October 1 
through September 30. GPRA data shall be submitted electronically to 
the National Data Warehouse (NDW). All GPRA data submitted shall be 
verifiable and based upon criteria set forth for each GPRA

[[Page 62553]]

performance standard. Monthly registration and workload data shall be 
exported to the NDW. All data shall be exported by the cutoff date for 
that fiscal year. A GPRA Developmental Report shall be run at the end 
of the second and fourth quarters and sent to the National GPRA Support 
Team at [email protected] by the required due dates.
2. Uniform Data System (UDS)
    UDS reporting period shall be by calendar year. The UDS reports 
shall be due in January for the previous calendar year.
3. Quarterly Immunization Report
    Quarterly Immunization Reports are required and submitted to the 
online National Immunization Reporting System (NIRS) (https://www.ihs.gov/NonMedicalPrograms/ihpes/immunizations/index.cfm?module=immunizations&option=home). Grantees are required to 
submit immunization coverage reports on children 3 to 27-month-old, 2-
year-old, Adolescent, Adult, and Influenza on a quarterly basis. For 
sites not using the IHS RPMS, visit the Division of Epidemiology and 
Disease Prevention (DEDP), Vaccine-Preventable Diseases Reports website 
to access non-RPMS quarterly reporting forms. An Excel spreadsheet with 
the required data elements can be found under the ``Non-RPMS Quarterly 
Reporting Forms'' section at https://www.ihs.gov/epi/vaccine/reports/.
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.The 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
    Should you successfully compete for an award, 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 (including gender 
identity, sexual orientation, and pregnancy). This includes ensuring 
programs are accessible to persons with limited English proficiency and 
persons with disabilities. 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 https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html.
     Recipients of FFA must ensure that their programs are 
accessible to persons with limited English proficiency. For guidance on 
meeting your legal obligation to take reasonable steps to ensure 
meaningful access to your programs or activities by limited English 
proficiency individuals, 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 information on your specific legal obligations for 
serving qualified individuals with disabilities, including reasonable 
modifications and making services accessible to them, see https://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, see https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html.
     For guidance on administering your program in compliance 
with applicable Federal religious nondiscrimination laws and applicable 
Federal conscience protection and associated anti-discrimination laws, 
see https://www.hhs.gov/conscience/conscience-protections/index.html 
and https://www.hhs.gov/conscience/religious-freedom/index.html.
F. Federal Awardee Performance and Integrity Information System 
    The IHS is required to review and consider any information about 
the applicant that is in the 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, 
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.
    All applicants and recipients must disclose in writing, in a timely 
manner, 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].


[[Page 62554]]

    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 part 180 and 2 CFR part 

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Debi 
Nalwood, Health System Specialist, Indian Health Service, Office of 
Urban Indian Health Programs, 5600 Fishers Lane, Mail Stop: 08E65D, 
Rockville, MD 20857, Phone: (240) 701-0882, Email: 
[email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Pallop Chareonvootitam, Grants Management Specialist, 
Indian Health Service, Division of Grants Management, 5600 Fishers 
Lane, Mail Stop: 09E70, Rockville, MD 20857, Phone: (301) 443-2195, 
Email: [email protected].
    3. Questions on systems matters may be directed to: Paul Gettys, 
Acting Director, Division of Grants Management, 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. 2021-24577 Filed 11-9-21; 8:45 am]