[Federal Register Volume 87, Number 93 (Friday, May 13, 2022)]
[Pages 29346-29354]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-10241]



Indian Health Service

Public Health Nursing Case Management: Reducing Sexually 
Transmitted Infections

    Announcement Type: New.
    Funding Announcement Number: HHS-2022-IHS-PHN-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.383.

Key Dates

    Application Deadline Date: August 11, 2022.
    Earliest Anticipated Start Date: September 26, 2022.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for a 
cooperative agreement for Public Health Nursing Case Management: 
Reducing Sexually Transmitted Infections. This program 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. 1621q, 
1660e. This program is described in the Assistance Listings located at 
https://sam.gov/content/home (formerly known as the CFDA) under 93.383.


    The IHS Public Health Nursing (PHN) program is a community health 
nursing program that focuses on the goals of promoting health and 
quality of life, and preventing disease and disability. The PHN program 
provides quality, culturally sensitive health promotion and disease 
prevention nursing care services through primary, secondary, and 
tertiary prevention services to individuals, families, and community 
groups. Program funds provide critical support for direct health care 
services in the community, which improve Americans' access to health 
care. The PHN program supports population-focused services to promote 
healthier communities through community based nursing services, 
community development, and health promotion and/or disease prevention 
activities. The PHN program promotes the establishment of program plans 
based on community assessments and evaluations to prevent disease, 
promote health, and implement community based programs. There is an 
emphasis on screening, home visits, immunizations, maternal-child 
health care, elder care, chronic disease, school services, health 
promotion and disease prevention, case management, population based 
services, and community disease surveillance. The PHN program is 
available to support transitions of care from the clinical setting into 
the community with an emphasis on the clinical, preventive, and public 
health needs of American Indian/Alaska Native (AI/AN) communities.
    PHN patient care coordination activities aim to serve the patient 
and family in the home and in the community. Preventive health care 
informs populations, promotes healthy lifestyles, and provides early 
treatment for illnesses. The PHN's expertise in communicable disease 
assessment, outreach, investigation, and surveillance aids in the 
management and prevention of the spread of communicable diseases. PHNs 
conduct nurse home visiting services via referral for communicable 
disease investigation and treatment, which includes such services as 
health education/behavioral counseling for health promotion, risk 
reduction, and immunizations to prevent illnesses with a goal to detect 
and treat problems in their early stages. The PHN's unique scope of 
service supports the goal of decreasing sexually transmitted diseases.


    The purpose of this IHS program is to mitigate the prevalence of 
sexually transmitted infections (STI) within Indian Country through a 
case management model that utilizes the PHN as a case manager. The 
emphasis is on raising awareness of STIs as a high-priority health 
issue among AI/AN communities and to support prevention and control 
activities of comorbid conditions. Case management involves the client, 
family, and other members of the health care team. Quality of care, 
continuity, and assurance of appropriate and timely interventions are 
also crucial. In addition to reducing the cost of health care, case 
management has proven its worth in terms of improving rehabilitation, 
improving quality of life, and increasing client satisfaction and 
compliance by promoting client self-determination. The goals and 
outcomes of the PHN case management model are early detection, 
diagnosis, treatment, and evaluation that will improve health

[[Page 29347]]

outcomes in a cost effective manner. This model uses all prevention 
components of primary, secondary, and tertiary prevention in the home 
and community with patient and family.
    The PHN Case Management program supports raising awareness of 
rising STI rates, increasing access to care, strengthening 
surveillance, and decreasing serious health consequences of undiagnosed 
STIs. This also supports timely linkage to care in follow-up and 
treatment to reduce the spread of STIs. The IHS goal is to support and 
strengthen surveillance systems to monitor STI trends, promote 
awareness, and identify effective interventions for reducing morbidity 
and improving outbreak response efforts. Currently, AI/AN men and women 
are disproportionately affected by STIs compared to other populations 
within the United States. Chlamydia and gonorrhea rates are four to 
five times higher in AI/AN populations than non-Hispanic whites. 
Syphilis and human immunodeficiency virus (HIV) also have 
disproportionately higher impact on AI/AN people. In 2019, AI/AN women 
had the highest syphilis rate at seven times the rate among non-
Hispanic white females. Effective diagnosis, management, and prevention 
of STIs requires a combination of clinical and public health 

Required, Optional, and Allowable Activities

    The community based case management model addresses the PHN scope 
of practice of working with individuals and families in a population-
based practice. The project will be applied in a phased approach, using 
the nursing process--assessment, planning, implementation, and 
    First Phase: Assessment--Complete a community assessment within the 
first six months after the project start date (most PHN programs have 
this readily available as a part of their annual program plans). 
Include, if available, data from local community assessments and STI 
data in the assessment. In addition, obtain input from key stake-
holders such as community members, Tribal leaders, health care 
administration, local social hygiene staff as subject matter experts, 
and community health groups to determine the STI health care 
priorities. Obtain approval for the establishment of the PHN case 
management program from health care administration, governing boards, 
and medical executive committees as needed.
    Second Phase: Planning--Based on the community assessment, the 
population of need related to STIs is identified and the planning of 
the case management project begins. Develop case management services no 
later than 10 months after the project start date, which addresses the 
priority STIs identified from the community assessment. Collaborate 
with local social hygiene and health care programs on planning in this 
phase. Plan specific guidelines for the case management services of the 
high-risk group of patients such as admission criteria, caseload size, 
policies and procedures, electronic health record reminders for 
providers and patients, and an evaluation plan to include data tracking 
for outcomes generated. Establish short and long term program goals. 
Identify if there is a best practice case management model available to 
replicate to target the identified high risk population. Obtain 
additional staff training needed for the community based nurse case 
management model such as evidence based practices, motivational 
interviewing, nurse competencies, quality improvement, and any other 
educational training that would be applicable to the health issues 
identified in the case management model. Identify or develop patient 
education materials and community education materials for the program. 
Develop plans for project sustainability.
    Third Phase: Implementation--The case management program includes 
admission criteria of the high risk population, caseload size, and 
appropriate health care standards. Establish patient caseload no later 
than 12 months after the project start date. Monitor progress and make 
adjustments as needed. Track patient data outcomes. Continue to plan 
ongoing sustainability of the program after the period of performance 
    Fourth Phase: Patient Satisfaction--In order to evaluate program 
services, initiate a patient satisfaction program no later than the 
start of the second year of the period of performance, such as one that 
provides patients with an opportunity to provide feedback on their 
experiences to assess the satisfaction of the services. Analyze 
findings so a concentrated effort is made to relate the customer 
satisfaction results to internal process metrics, and examine trends 
over time in order to take action on a timely basis. Evaluate and 
revise the case management program if needed, review policies and 
procedures, education materials, and staff competencies semi-annually. 
To the extent permitted by law, report back to key stake-holders 
progress of the project, especially to inform clients about changes 
brought about as a direct result of listening to their needs. Each site 
will share program material with the IHS Headquarters PHN program. This 
information will be shared IHS-wide for replication of the project 
across the IHS with credit given to the organization that developed the 
material. Poster or oral presentation will be given at national 
meetings and/or webinars.

II. Award Information

Funding Instrument--Cooperative Agreement

Estimated Funds Available
    The total funding identified for fiscal year (FY) 2022 is 
approximately $1,500,000. Individual award amounts for the first budget 
year are anticipated to be between $145,000 and $150,000. 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 10 awards will be issued under this program 
Period of Performance
    The period of performance is 5 years.
Cooperative Agreement
    Cooperative agreements awarded by the Department of Health and 
Human Services (HHS) are administered under the same policies as 
grants. However, the funding agency, IHS, is anticipated to have 
substantial programmatic involvement in the project during the entire 
period of performance. Below is a detailed description of the level of 
involvement required of the IHS.
Substantial Agency Involvement Description for Cooperative Agreement
    Provide funded organizations with ongoing consultation and 
technical assistance to plan, implement, and evaluate each component of 
the comprehensive program as described under Recipient Activities 
below. Consultation and technical assistance will include, but not be 
limited to, the following areas:
    1. Interpretation of current literature related to epidemiology, 
statistics, surveillance, Healthy People 2030 Objectives, the Goals of 
the IHS National STD program, Centers for Disease Control and 
Prevention Sexually Transmitted Infections

[[Page 29348]]

Treatment Guidelines, 2021, Department of Health and Human Services STI 
Strategic Plan, and previous best practices of PHN Case Management 
recipient activities;
    2. Identify sources for additional staff training for the community 
based case management model and additional training needed such as 
evidence based practices, motivational interviewing, performance 
improvement and any other training that would be applicable to the STI 
issues addressed in the case management program;
    3. Design and implementation of program components (including, but 
not limited to, program implementation methods, recommendation of a 
community assessment tool, surveillance, analysis, development of 
programmatic evaluation, and coordination of activities);
    4. Identify, if available, previously established program 
management plans of PHN Case Management best practices (to replicate 
from previous demonstration PHN program awards);
    5. Conduct visits to assess program progress and mutually resolved 
problems, if travel funds are available; and,
    6. Coordinate these activities with all IHS PHN activities on a 
national basis.

III. Eligibility Information

1. Eligibility

    To be eligible for this funding opportunity an applicant must be 
one of the following as defined by 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(1)): ``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 Urban Indian organization, as defined by 25 U.S.C. 
1603(29). 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 Tribal Resolutions, 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
Tribal Resolution
    The DGM must receive an official, signed Tribal Resolution prior to 
issuing a Notice of Award (NoA) to any Tribe or Tribal organization 
selected for funding. An applicant 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 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:
     Application forms:
    1. SF-424, Application for Federal Assistance.
    2. SF-424A, Budget Information--Non-Construction Programs.
    3. SF-424B, Assurances--Non-Construction Programs.
    4. Project Abstract Summary form.
     Project Narrative (not to exceed 10 pages). See Section 
IV.2.A, Project Narrative for instructions.
     Budget Narrative (not to exceed four pages). See Section 
IV.2.B, Budget Narrative for instructions.
     One-page Timeframe Chart.
     Tribal Resolution(s) as described in Section III, 
Eligibility (if applicable).
     501(c)(3) Certificate as described in Section III, 
Eligibility (if applicable).
     Biographical sketches for all Key Personnel.
     Contractor/Consultant resumes or qualifications and scope 
of work.

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     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://facdissem.census.gov/.
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 
10 pages and must: (1) Have consecutively numbered pages; (2) use black 
font 12 points or larger (tables may be done in 10 point font); (3) be 
single-spaced; and (4) be formatted to fit standard letter paper (8\1/
2\ x 11 inches). Do not combine this document with any others.
    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 overall page limit, the application will be considered not 
responsive and will not be reviewed. The 10-page limit for the project 
narrative does not include the work plan, standard forms, Tribal 
Resolutions, budget, budget narratives, and/or other items. Page limits 
for each section within the project narrative are guidelines, not hard 
    There are three parts to the project narrative: Part 1--Program 
Information; Part 2--Program Planning and Evaluation; and Part 3--
Program Report. 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: Needs
    Describe the Urban Program or Tribe's current social hygiene or STI 
program activities, how long it has been operating, and what programs 
or services are currently being provided. Describe how the applicant 
has determined it has the administrative infrastructure to support the 
activities to implement a Public Health Nursing Case Management Program 
and evaluate and sustain it. Explain previous planning activities the 
applicant has completed relevant to this or similar goals. Describe any 
internal relationships or collaborative relationships with social 
hygiene/STI subject matter experts to support this activity.
Part 2: Program Planning and Evaluation (Limit--4 Pages)
Section 1: Program Plans
    Describe fully and clearly the direction the applicant plans to 
take in the PHN Case Management Program, including plans to demonstrate 
improved sexual health outcomes of the identified group of patients and 
services to the community it serves. Include proposed timelines.
Section 2: Program Evaluation
    Describe fully and clearly the improvements that will be made by 
the applicant to manage the PHN Case Management Program and identify 
the anticipated or expected benefits for the Tribe and AI/AN people 
Part 3: Program Report (Limit--2 Pages)
    Section 1: Identify and describe significant program achievements 
associated with the delivery of quality health care services in the 
past 24 months as a part of implementing previous grant awards, 
cooperative agreements, or other related activities. Provide a 
comparison of the actual accomplishments to the goals established for 
the period of performance or, if applicable, provide justification for 
the lack of progress.
B. Budget Narrative (Limit--4 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 applicant can submit with the budget 
narrative a more detailed spreadsheet than is provided by the SF-424A 
(the spreadsheet will not be considered part of the budget narrative). 
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 

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]), Deputy 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 not allowable.
     The available funds are inclusive of direct and indirect 
     Only one cooperative agreement may be awarded per 

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 you cannot submit an application through Grants.gov, you must 
request a

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waiver prior to the application due date. This contact must be 
initiated prior to the application due date or your waiver request will 
be denied. Prior approval must be requested and obtained from Mr. Paul 
Gettys, Deputy Director, DGM. You must send a written waiver request 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 must include clear 
justification for the need to deviate from the required application 
submission process.
    If the DGM approves your waiver request, you will receive a 
confirmation of approval email containing submission instructions. You 
must include a copy of the written approval with the application 
submitted to the DGM. Applications that do not include a copy of the 
signed waiver from the Deputy 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).
     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, you will receive an 
automatic acknowledgment from Grants.gov that contains a Grants.gov 
tracking number. The IHS will not notify you that the application has 
been received.
System for Award Management (SAM)
    Organizations that are not registered with SAM must access the SAM 
online registration through the SAM home page at https://sam.gov. 
United States (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.
Unique Entity Identifier
    Your SAM.gov registration now includes a Unique Entity Identifier 
(UEI), generated by SAM.gov, which replaces the DUNS number obtained 
from Dun and Bradstreet. SAM.gov registration no longer requires a DUNS 
    Check your organization's SAM.gov registration as soon as you 
decide to apply for this program. If your SAM.gov registration is 
expired, you will not be able to submit an application. It can take 
several weeks to renew it or resolve any issues with your registration, 
so do not wait.
    Check your Grants.gov registration. Registration and role 
assignments in Grants.gov are self-serve functions. One user for your 
organization will have the authority to approve role assignments, and 
these must be approved for active users in order to ensure someone in 
your organization has the necessary access to submit an application.
    The Federal Funding Accountability and Transparency Act of 2006, as 
amended (``Transparency Act''), requires all HHS awardees to report 
information on sub-awards. Accordingly, all IHS awardees must notify 
potential first-tier sub-awardees that no entity may receive a first-
tier sub-award unless the entity has provided its UEI number to the 
prime awardee 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.
    Additional information on implementing the Transparency Act, 
including the specific requirements for 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 narratives. 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 (5 Points)
    a. Provide demographic information, prevalence rates of sexually 
transmitted infections, and baseline data to support the case 
management for the high risk group of patients.
    b. Describe how data collection will support the project objectives 
and how it will support the project evaluation in order to determine 
the impact of the project. Address how the proposed project will result 
in health improvements.
B. Project Objective(s), Work Plan, and Approach (35 Points)
a. Goals and Objectives (15 Points)
    Identify two to three measurable objectives of the program that 
will demonstrate outcome. Goals/Objectives should be specific with a 
realistic timeline.
b. Methodology/Activities (20 Points)
    Describe the activities that will be implemented in the program to 
meet the objectives. This work plan should be directly related to the 
    i. Describe how you will monitor the objectives (chart reviews, 
patient comments/feedback, data collection tools).
    ii. Describe any collaborative efforts with other programs or the 
local social hygiene program.
C. Program Evaluation (20 Points)
    Describe the methods for evaluating the project activities. Each 

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project objective should have an evaluation component and the 
evaluation activities should appear on the program plan. At a minimum, 
projects should describe plans to collect or summarize evaluation 
information about all project activities. Please address the following 
for each of the proposed objectives:
    (1) Describe the community assessment results and what data will be 
selected to evaluate the success of the objective(s).
    (2) Describe how the data and patient satisfaction information will 
be collected to assess the programs objective(s) (e.g., methods used 
such as, but not limited to, providing mechanisms for patients to 
provide feedback on their experiences).
    (3) Identify when the data will be collected and the data analysis 
    (4) Describe the extent to which there are specific datasets, 
databases, or registries already in place to measure/monitor meeting 
    (5) Describe who will collect the data and any cost of the 
evaluation (whether internal or external).
    (6) Describe where, when, and to whom the data will be presented 
(only to the extent permitted by law, the data to be reported back to 
key stake-holders on the progress of the project, especially to inform 
clients about changes brought about as a direct result of listening to 
their needs).
    (7) Address anticipated obstacles to the success of the proposal 
such as underlying causes and the nature of their influence on 
accomplishing the objectives.
    (8) Describe how the community assessment will be used to identify 
a high risk group of patients.
    (9) Describe the process that will be used to follow-up on the PHN 
Case Management Project findings/conclusions.
D. Organizational Capabilities, Key Personnel, and Qualifications (25 
    This section outlines the broader capacity of the organization to 
complete the project outlined in the work plan. It includes the 
identification of personnel responsible for completing tasks and the 
chain of responsibility for successful completion of the project 
outlined in the work plan.
    (1) Describe the organizational structure.
    (2) Describe what equipment and facility space (i.e., office space) 
will be available for use during the proposed program. Include 
information about any equipment not currently available that will be 
purchased throughout the agreement.
    (3) List key personnel who will work on the project.
    i. Identify staffing plan, existing personnel, and new program 
staff to be hired.
    ii. Include position descriptions and resumes for all key 
personnel. Position descriptions should clearly describe each position 
and duties indicating desired qualifications, experience, and 
requirements related to the proposed project and how they will be 
    iii. If the project requires additional personnel beyond those 
covered by the grant award (i.e., information technology support, 
volunteers, interviewers, etc.), note these and address how these 
positions will be filled and, if funds are required, the source of 
these funds.
    iv. If personnel are to be only partially funded by this grant, 
indicate the percentage of time to be allocated to this project and 
identify the resources used to fund the remainder of the individual's 
    (4) Capability.
    i. Briefly describe the facility and user population.
    ii. Describe the organization's ability to conduct this initiative 
through linkages to community resources: Partnerships established to 
provide referrals for additional services as needed for specialized 
treatment, care, and counseling services.
E. Categorical Budget and Budget Justification (15 Points)
    Provide a clear estimate of the program costs and justification for 
expenses. The budget and budget justification should be consistent with 
the tasks identified in the work plan. The budget focus should be on 
developing and sustaining PHN case management services.
    (1) Provide a budget narrative that serves as justification for all 
costs, explaining why each line item is necessary or relevant to the 
proposed project. Include sufficient details to facilitate the 
determination of allowable costs.
    (2) Provide a succinct description of specific roles and activities 
of each person involved in the proposed project budget.
    (3) If indirect costs are claimed, indicate and apply the current 
negotiated rate to the budget.
Multi-Year Project Requirements
    Applications must include a brief project narrative and budget (one 
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 
    These can include:
     Work plan, logic model, and/or time line for proposed 
     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, period of performance limit) 
will not be referred to the ORC and will not be funded. The program 
office will notify the applicant 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 Public Health Nursing program 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 award, the terms and conditions of the 
award, the effective date of the award, the budget period, and period 
of performance. 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 

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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/retrieveECFR?gp&;SID=2970eec67399fab1413ede53d7895d99&mc=true&
    C. Grants Policy:
     HHS Grants Policy Statement, Revised January 2007, at 
    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 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 awardees that request reimbursement of 
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 recipients 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 awardee 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 reporting 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 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.
    Awardees are responsible and accountable for reporting accurate 
information on all required reports: The Progress Reports and the 
Federal Financial Report.
C. Data Collection and Reporting
    The recipient must submit required reports consistent with the 
applicable deadlines. The recipient is required to identify two to 
three measurable objectives of the program to demonstrate and trend 
outcome. The objectives correspond to the work plan should be directly 
related to the targeted outcome.

[[Page 29353]]

The recipient is to describe and report this information on a semi-
annual timeline and in annual 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. Non-Discrimination Legal Requirements for Recipients of Federal 
Financial Assistance
    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/civil-rights/for-individuals/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/fapiis/#/home, 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, Deputy 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]


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 and 2 CFR part 

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Ms. 
Jolene Tom, RN/BSN Project Officer, Indian Health Service, 5600 Fishers 
Lane, Mail Stop: 08N40C, Rockville, MD 20857, Phone: (301) 945-3215, 
Fax: (301) 594-6213, Email: [email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Sheila Miller, Grants Management Specialist, Indian Health 
Service, Division of Grants Management, 5600 Fishers Lane, Mail Stop: 
09E70, Rockville, MD 20857, Phone: (240) 535-9308, Email: 
[email protected].

[[Page 29354]]

    3. Questions on systems matters may be directed to: Paul Gettys, 
Deputy 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. 2022-10241 Filed 5-12-22; 8:45 am]