[Federal Register Volume 88, Number 85 (Wednesday, May 3, 2023)]
[Notices]
[Pages 27905-27915]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-09363]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Community Health Aide Program: Tribal Planning & Implementation

    Announcement Type: New.
    Funding Announcement Number: HHS-2023-IHS-TPI-0001.
    Assistance Listing (Catalog of Federal Domestic Assistance or CFDA) 
Number: 93.382.

Key Dates

    Application Deadline Date: August 1, 2023.
    Earliest Anticipated Start Date: September 15, 2023.

I. Funding Opportunity Description

Statutory Authority

    The Indian Health Service (IHS) is accepting applications for 
grants for the Community Health Aide Program (CHAP) Tribal Planning and 
Implementation (TPI) program. The CHAP is authorized under the Snyder 
Act, 25 U.S.C. 13; the Transfer Act, 42 U.S.C. 2001(a); and the Indian 
Health Care Improvement Act, 25 U.S.C. 1616l. The Assistance Listings 
section of SAM.gov (https://sam.gov/content/home) describes this 
program under 93.382.

Background

    The national CHAP will provide a network of health aides trained to 
support licensed health professionals while providing direct health 
care, health promotion, and disease prevention services. These 
providers will work within a referral relationship under the 
supervision of licensed clinical providers that includes clinics, 
service units, and hospitals. The program will increase access to 
direct health services, including inpatient and outpatient visits.
    The Alaska CHAP has become a model for efficient and high quality 
health care delivery in rural Alaska providing approximately 300,000 
patient encounters per year and responding to emergencies 24 hours a 
day, 7 days a week. Specialized providers in dental and behavioral 
health were later introduced to respond to the needs of patients and 
address the health disparities in oral health and mental health amongst 
American Indians and Alaska Natives.
    The national CHAP is a workforce model that includes three 
different provider types that act as extenders of licensed clinical 
supervisors. The national CHAP currently includes a behavioral health 
aide, community health aide, and dental health aide. Each of the health 
aide categories operate in a tiered level practice system. The national 
CHAP model provides an opportunity for increased access to care through 
the extension of primary care, dental, and behavioral health 
clinicians.
    In 2010, under the permanent reauthorization of the Indian Health 
Care Improvement Act (IHCIA), Congress provided the Secretary of Health 
and Human Services, acting through the IHS, the authority to expand the 
Alaska CHAP program. In 2016, the IHS initiated Tribal Consultation on 
expanding the CHAP to the contiguous 48 states. In 2018, the IHS formed 
the CHAP Tribal Advisory Group (TAG) and began developing the program. 
In 2020, the IHS announced the national CHAP policy, which formally 
created the national CHAP.

Purpose

    The purpose of the TPI program is to support the planning and 
implementation for Tribes and Tribal Organizations (T/TO) positioned to 
begin operating a CHAP or support a growing CHAP in the contiguous 48 
states. The program is designed to support the regional flexibility 
required to implement a CHAP unique to the needs of individual Tribal 
communities across the country through the identification of 
feasibility factors. The focus of the program is to:
    1. Develop clinical supervisor support for primary care, behavioral 
health, and dental health clinicians providing both direct and indirect 
supervision of prospective health aides;
    2. Identify area and community-specific health care needs of 
patients that can be addressed by the health aides;
    3. Identify and develop a technology infrastructure plan for the 
mobility and success of health aides in anticipation of providing 
services;
    4. Develop a training plan to include partners across the T/TO's 
geographic region to enhance the training opportunities available to 
prospective health aides to include continuing education and clinical 
practice;
    5. Identify best practices for integrating a CHAP workforce into an 
existing Tribal health system;

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    6. Address social determinants of health that impact the 
recruitment and retention of prospective health aides; and
    7. Identify the total cost of full implementation of a CHAP within 
an existing Tribal health system.

II. Award Information

Funding Instrument--Grant

Estimated Funds Available
    The total funding identified for fiscal year (FY) 2023 is 
approximately $3,000,000. Individual award amounts are anticipated to 
be between $900,000 and $1,000,000. 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 three to five awards will be issued under this 
program announcement. The IHS intends to award no more than one grant 
per IHS area.
Period of Performance
    The period of performance is 2 years.

I. Eligibility Information

1. Eligibility

    To be eligible for this funding opportunity, an applicant must be 
one of the following as defined under 25 U.S.C. 1603:
     A federally recognized Indian Tribe as defined by 25 
U.S.C. 1603(14). The term ``Indian Tribe'' means any Indian Tribe, 
band, nation, or other organized group or community, including any 
Alaska Native village or group, or regional or village corporation, as 
defined in or established pursuant to the Alaska Native Claims 
Settlement Act (85 Stat. 688) [43 U.S.C. 1601 et seq.], which is 
recognized as eligible for the special programs and services provided 
by the United States (U.S.) 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(l)): ``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.
    The Division of Grants Management (DGM) will notify any applicants 
deemed ineligible.

2. Additional Information on Eligibility

    The IHS does not fund concurrent projects. If an applicant is 
successful under this announcement, any subsequent applications in 
response to other TPI announcements from the same applicant will not be 
funded. Applications on behalf of individuals (including sole 
proprietorships) and foreign organizations are not eligible and will be 
disqualified from competitive review and funding under this funding 
opportunity.
    Specifically, an applicant may not apply to both this opportunity, 
TPI, and the CHAP Tribal Assessment and Planning (TAP) opportunity 
(number HHS-2023-IHS-TAP-0001).
    An organization currently carrying out a CHAP in the U.S. in 
accordance with 25 U.S.C. 1616l through an Indian Self-Determination 
and Education Assistance Act (ISDEAA) agreement is eligible to apply, 
but may not utilize the funds to carry out a CHAP.

    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 non-profit status, 
etc.

3. Cost Sharing or Matching

    The IHS does not require matching funds or cost sharing for grants 
or cooperative agreements.

4. 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 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 T/O 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.
    Applicants 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

    Grants.gov uses a Workspace model for accepting applications. The 
Workspace consists of several online forms and three forms in which to 
upload documents--Project Narrative, Budget Narrative, and Other 
Documents. Give your files brief descriptive names. The filenames are 
key in finding specific documents during the objective review and in 
processing awards. Upload all requested and optional documents 
individually, rather than combining them into a single file. Creating a 
single file creates confusion when trying to find specific documents. 
Such confusion can contribute to delays in processing awards, and could 
lead to lower scores during the objective review.

1. Obtaining Application Materials

    The application package and detailed instructions for this 
announcement are available on https://www.Grants.gov.

[[Page 27907]]

    Please direct questions regarding the application process to 
[email protected].

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 15 pages). See Section 
IV.2.A Project Narrative for instructions.
    1. Background information on the organization.
    2. Proposed scope of work, objectives, and activities that provide 
a description of what the applicant plans to accomplish.
     Budget Justification and Narrative (not to exceed 5 
pages). See Section IV.2.B Budget Narrative for instructions.
     One-page Timeframe Chart.
     Tribal Resolution(s).
     Letters of Support from organization's Board of Directors 
(if applicable).
     501(c)(3) Certificate.
     Biographical sketches for all Key Personnel.
     Contractor/Consultant resumes or qualifications and scope 
of work.
     Disclosure of Lobbying Activities (SF-LLL), if applicant 
conducts reportable lobbying.
     Certification Regarding Lobbying (GG-Lobbying Form).
     Copy of current Negotiated Indirect Cost rate (IDC) 
agreement (required in order to receive IDC).
     Organizational Chart (optional).
     Documentation of current Office of Management and Budget 
(OMB) Financial Audit (if applicable).
    Acceptable forms of documentation include:
    1. Email confirmation from Federal Audit Clearinghouse (FAC) that 
audits were submitted; or
    2. Face sheets from audit reports. Applicants can find these on the 
FAC website at https://facdissem.census.gov/ 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 15 pages and must: (1) have consecutively numbered 
pages; (2) use black font 12 points or larger; (3) be single-spaced; 
and (4) be formatted to fit standard letter paper (8\1/2\ x 11 inches). 
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 page limit, the reviewers will be directed to ignore any 
content beyond the page limit. The 15-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 
limits.
    There are three parts to the project narrative: Part 1--Program 
Information; Part 2--Program Planning; Part 3--Program Evaluation; and 
Part 4--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: Community Profile
    Describe the demographics of the community including but not 
limited to geography, languages, age, and socioeconomic status. The 
community profile should include data specific to the community that 
would benefit from the implementation of the CHAP. Include a brief 
summary of information obtained through use of a Tribal and Assessment 
Planning Grant if applicable.
Section 2: Health & Infrastructure Needs
    Describe the community's current health disparities related to 
primary, behavioral, and oral health care. The needs section should 
provide facts and evidence related to infrastructure barriers (e.g., 
recruitment, retention, and access to facilities). Include a brief 
summary of information obtained through use of a Tribal and Assessment 
Planning Grant if applicable.
Section 3: Organizational Capacity
    Describe the T/TO's current health program activities, how long it 
has been operating, and what programs or services are currently being 
provided. Describe in full the organization's infrastructure and its 
ability to assess the feasibility of implementing a CHAP and 
identifying significant barriers that could prohibit the 
implementation. Include a brief summary of any information obtained 
through use of a Tribal Assessment and Planning Grant.
Part 2: Program Planning and Evaluation (limit--6 pages)
Section 1: Program Plans
    Describe in full the direction the T/TO plans to take in the CHAP 
TPI. The program plan should identify the plan, including how all 
aspects of the implementation will be based in Tribal culture and how 
the program plan will address Tribal infrastructure needs specific to:
     Clinical infrastructure and clinical operations.
     Workforce development including supervision plans for CHAP 
providers that address community and region specific needs.
     Training infrastructure (including continuing education).
     Technology infrastructure.
     System integration.
     Implementation cost.
Section 2: Program Activities
    Describe in full how the applicant will develop a robust clinical 
infrastructure to support clinical operations specific to CHAP 
providers. The activities should include how the applicant will 
correlate the community health needs with the CHAP program needs, 
including specific cultural elements. Include how the applicant will 
develop position descriptions, the scope of work of health aides, 
policy development, and a detailed plan of how to adjust the clinical 
operations to incorporate CHAP providers. Describe how CHAP providers 
will be trained, specific to the regional resources, include continuing 
education training plans. Describe how the CHAP providers will be 
supervised including staffing plans for CHAP provider supervision. List 
the available technology and detail how the current technology 
infrastructure will be utilized to support the CHAP providers, 
including aiding in provider mobility or how it will be built specific 
to the needs of the CHAP program, both at the provider and the clinic 
level. Detail how the CHAP program will be integrated with the current 
system to provide maximization of provider and program to improve 
community health, including cultural components the program is uniquely 
positioned or

[[Page 27908]]

designed to address. Provide a detailed plan of how the award funds 
will be used by the applicant to implement the CHAP program, specific 
to the above implementation components.
Section 3: Staffing Plan
    Describe key staff tasked with carrying out the program activities 
carried out in Section 2. Applicants are highly encouraged to partner 
with other key stakeholders within the T/TO's region for a robust 
understanding of the needs and implications of implementing a CHAP into 
their respective communities.
Section 4: Timeline
    Describe a timeline not to exceed 2 years for the completion of the 
program plan, activities, and evaluation plan. Provide a timeline chart 
depicting a realistic timeline that details all major activities, 
milestones, and applicable staffing plans. The timeline should include 
the projected progress report due at the midpoint of the project 
period. The timeline chart should not exceed one page.
Part 3: Program Evaluation
Section 1: Evaluation Plan
    Please identify and describe significant program activities and 
achievements associated with the delivery of quality health services. 
Provide a plan to provide a comparison of the actual accomplishments to 
the goals established for the project period, or if applicable, provide 
justification for the lack of progress. The evaluation plan should 
address major categories related to (See Logic Model in Appendix):
     Clinical infrastructure and clinical operations. Describe 
how clinical infrastructure and operations have changed to incorporate 
and integrate the CHAP program. Include any data on referrals to CHAP 
providers, number of clinic providers making referrals to CHAP 
providers and demonstrated increases in health promotion and disease 
prevention efforts.
     Workforce development including supervision plans for CHAP 
providers that address community and region specific needs. Include 
data on outreach and recruiting activities, number of CHAP applications 
received, supervisors trained for each provider type.
     Training infrastructure (including continuing education). 
Describe where the training for each CHAP discipline will be provided 
and whether it will be delivered in person, virtually or hybrid. 
Summarize how oversight will be maintained to assure a high-quality 
training is achieved. Detail how each aspiring or advancing CHAP 
provider will be supported and supervised throughout any hands-on 
training. Include data on each item if available.
     Technology infrastructure. Describe what technology will 
be used and how it supports the CHAP program. Detail any changes made 
to existing technology infrastructure to incorporate CHAP providers. 
Include how CHAP provider charting will be integrated into electronic 
health records. List specific technology purchased or transferred to 
the CHAP program to support CHAP providers. Include information on 
network accessibility, specifically any barriers to accessibility and 
how this can be overcome.
     System integration. Describe in detail what barriers to 
integration have been overcome and how. List patient outreach and 
education, trainings provided to clinic staff, trainings specific to 
providers on how CHAP providers will integrate and extend licensed 
providers to achieve best practices and health benefits. Describe 
specific populations where CHAP may be focused such as prenatal, child 
vaccination, dental sealant placement, substance abuse screening, 
hospital discharge follow up, etc., and how the CHAP providers 
integrate their visits with existing clinic systems. Include any data 
that supports system integration changes.
     Implementation cost. Provide details on budgeted items, 
explaining any overages and what happened that created overages. 
Explain how any excess funds were re-allocated to fully utilize all 
grant funds.
Part 4: Program Report (limit--5 pages)
Section 1: Describe your organization's significant program activities 
and accomplishments over the past 5 years associated with the goals of 
this announcement. Please identify and describe significant program 
activities and achievements associated with the planning and 
implementation of the CHAP program. Provide a comparison of the actual 
accomplishments to the goals established for the project period, or if 
applicable, provide justification for the lack of progress.

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) for the first year of the project. 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 would support the 
achievement of proposed objectives. Be very careful about showing how 
each item in the ``Other'' category is justified. Do NOT use the budget 
narrative to expand the project narrative.
3. Submission Dates and Times
    Applications must be submitted through Grants.gov by 11:59 p.m. 
Eastern Time on the Application Deadline Date. Any application received 
after the application deadline will not be accepted for review. 
Grants.gov will notify the applicant via email if the application is 
rejected.
    If technical challenges arise and assistance is required with the 
application process, contact Grants.gov Customer Support (see contact 
information at https://www.Grants.gov). If problems persist, contact 
Mr. Paul Gettys, Deputy Director, DGM, by email at [email protected]. Please 
be sure to contact Mr. Gettys at least 10 days prior to the application 
deadline. Please do not contact the DGM until you have received a 
Grants.gov tracking number. In the event you are not able to obtain a 
tracking number, call the DGM as soon as possible.
    The IHS will not acknowledge receipt of applications.
4. Intergovernmental Review
    Executive Order 12372 requiring intergovernmental review is not 
applicable to this program.
5. Funding Restrictions
     Pre-award costs are allowable up to 90 days before the 
start date of the award provided the costs are otherwise allowable if 
awarded. Pre-award costs are incurred at the risk of the applicant.
     The available funds are inclusive of direct and indirect 
costs.
     Only one grant may be awarded per applicant.
6. Electronic Submission Requirements
    All applications must be submitted via Grants.gov. Please use the 
https://www.Grants.gov website to submit an application. Find the 
application by selecting the ``Search Grants'' link on the homepage. 
Follow the instructions for submitting an application under the Package 
tab. No other method of application submission is acceptable.
    If you cannot submit an application through Grants.gov, you must 
request a waiver prior to the application due date. You must submit 
your waiver request by email to [email protected]. Your waiver request must 
include clear justification for the need to deviate from the required

[[Page 27909]]

application submission process. The IHS will not accept any 
applications submitted through any means outside of Grants.gov without 
an approved waiver.
    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 
waiver approval from 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 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 
obtained.
     Applicants are strongly encouraged not to wait until the 
deadline date to begin the application process through Grants.gov as 
the registration process for SAM and Grants.gov could take up to 20 
working days.
     Please follow the instructions on Grants.gov to include 
additional documentation that may be requested by this funding 
announcement.
     Applicants must comply with any page limits described in 
this funding announcement.
     After submitting the application, 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
    Organizations that are not registered with the System for Award 
Management (SAM) must access the SAM online registration through the 
SAM home page at https://sam.gov. Organizations based in the U.S. 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 
number.
    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. 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 (10 points)
    Identify the proposed project and plans to fully implement a CHAP 
within their community. The needs should clearly identify the existing 
health system and how the CHAP will be integrated to meet the health 
needs of the community in the fields of behavioral, oral, and primary 
health care.
B. Project Objective(s), Work Plan, and Approach (30 points)
    The work plan should be comprised of two key parts: Program 
Information and Program Plan. Provide information related to three key 
sections: community profile; health and infrastructure; and 
organizational capacity. The Program Information part should 
demonstrate a robust community profile that highlights the existing 
health system, demographical data of community members and user 
population, and a detailed description of the T/TO carrying out the 
proposed activity. An acceptable Program Plan expecting to receive full 
points should include details of the applicants plan to address the 
program objective. The Program Plan should address at a minimum key 
activities related to clinical supervisor support, scope of work, 
technology infrastructure, training infrastructure, integration best 
practices, and auxiliary support to health aides that address social 
determinants.
C. Program Evaluation (30 points)
    The program evaluation should be comprised of two key sections: 
evaluation plan and outcome report. The evaluation plan should address 
major categories related to clinical supervisor support, enhanced scope 
of work, technology infrastructure, training infrastructure, 
integration best practices, auxiliary support, and full implementation 
costs (See Sample Logic Model in Appendix). The evaluation plan should 
identify how the T/TO plans to fully integrate CHAP. The evaluation 
should include total implementation costs based on the implementation 
plan and program plan identified including any significant

[[Page 27910]]

implementation barriers. List measurable and attainable goals with 
explicit timelines that detail expectation of findings. The Outcome 
Report should describe in full the findings of the program plan, 
evaluation, determination on stage of readiness for implementation and 
implementation activities. The outcome report should organize the 
findings into at least five of the six categories:
    1. Clinical infrastructure and clinical operations.
    2. Workforce development including supervision plans for CHAP 
providers that address community and region specific needs.
    3. Training infrastructure (including continuing education).
    4. Technology infrastructure.
    5. System integration.
    6. Implementation cost.
    Applicants are encouraged to identify additional categories above 
these six and may choose to develop subcategories that best fit the 
program plan.
D. Organizational Capabilities, Key Personnel, and Qualifications (10 
points)
    Provide a detailed biographical sketch of each member of key 
personnel assigned to carry out the objectives of the program plan. The 
sketches should detail the qualifications and expertise of identified 
staff.
E. Categorical Budget and Budget Justification (20 points)
    Provide a detailed budget of each expenditure directly related to 
the identified program activities.
    Additional documents can be uploaded as Other Attachments in 
Grants.gov. These can include:
     Work plan, logic model, and/or timeline for proposed 
objectives.
     Position descriptions for key staff.
     Resumes of key staff that reflect current duties.
     Consultant or contractor proposed scope of work and letter 
of commitment (if applicable).
     Current Indirect Cost Rate Agreement.
     Organizational chart.
     Map of area identifying project location(s).
     Additional documents to support narrative (i.e. data 
tables, key news articles, etc.).

2. Review and Selection

    Each application will be prescreened for eligibility and 
completeness as outlined in this funding announcement. Applications 
that meet the eligibility criteria shall be reviewed for merit by the 
Review Committee (RC) based on the 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 RC and will not be funded. The DGM 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 Office of Clinical and Preventive Services within 30 days of the 
conclusion of the RC 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 
information.
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 
policies:
    A. The criteria as outlined in this program announcement.
    B. Administrative Regulations for Grants:
     Uniform Administrative Requirements, Cost Principles, and 
Audit Requirements for HHS Awards currently in effect or implemented 
during the period of award, other Department regulations and policies 
in effect at the time of award, and applicable statutory provisions. At 
the time of publication, this includes 45 CFR part 75, at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75.pdf.
     Please review all HHS regulatory provisions for 
Termination at 45 CFR 75.372, at the time of this publication located 
at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-sec75-372.pdf.
    C. Grants Policy:
     HHS Grants Policy Statement, Revised January 2007, at 
https://www.hhs.gov/sites/default/files/grants/grants/policies-regulations/hhsgps107.pdf.
    D. Cost Principles:
     Uniform Administrative Requirements for HHS Awards, ``Cost 
Principles,'' at 45 CFR part 75 subpart E, at the time of this 
publication located at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75-subpartE.pdf.
    E. Audit Requirements:
     Uniform Administrative Requirements for HHS Awards, 
``Audit Requirements,'' at 45 CFR part 75 subpart F, at the time of 
this publication located at https://www.govinfo.gov/content/pkg/CFR-2021-title45-vol1/pdf/CFR-2021-title45-vol1-part75-subpartF.pdf.
    F. As of August 13, 2020, 2 CFR part 200 was updated to include a 
prohibition on certain telecommunications and video surveillance 
services or equipment. This prohibition is described in 2 CFR part 
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 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 award 
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

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place until the current rate agreement is provided to the DGM.
    Per 2 CFR 200.414(f) Indirect (F&A) costs,

any non-Federal entity (NFE) [i.e., applicant] that does not have a 
current negotiated 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 200.403, 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 can be used by 
applicants that have 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 
award.
    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 write 
to [email protected].

3. Reporting Requirements

    The recipient 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 
award, 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 recipient 
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 use the form under the 
Recipient User section of https://www.grantsolutions.gov/home/getting-started-request-a-user-account/. Download the Recipient User Account 
Request Form, fill it out completely, and submit it as described on the 
web page and in the form.
    The reporting requirements for this program are noted below.
A. Progress Reports
    Program progress reports are required annually. The progress 
reports are due within 90 days after the budget period ends (specific 
dates will be listed in the NoA Terms and Conditions). These reports 
must include a brief comparison of actual accomplishments to the goals 
established for the period, a summary of progress to date or, if 
applicable, provide sound justification for the lack of progress, and 
other pertinent information as required. A final report must be 
submitted within 120 days of expiration of the period of performance.
B. Financial Reports
    Federal Financial Reports are due 90 days after the end of each 
budget period, and a final report is due 120 days after the end of the 
period of performance. Recipients are responsible and accountable for 
reporting accurate information on all required reports: the Progress 
Reports and the Federal Financial Report.
    Failure to submit timely reports may result in adverse award 
actions blocking access to funds.
C. Data Collection and Reporting
    At the conclusion of the program period, the outcome report should 
detail how the T/TO plans to completely integrate CHAP into their 
Tribal health system and list major barriers that could potentially 
impact full integration. The Outcome Report should describe in full the 
findings of the program plan and evaluation, and plans for 
implementation. The outcome report should organize the findings of the 
key categories:
    1. Clinical Supervisor Support.
    2. Scope of Practice.
    3. Technology Infrastructure.
    4. Training Plan.
    5. System Integration.
    6. Auxiliary Support to Address Social Determinants.
    Based on the findings and measureable outcomes of the categories, 
the applicant should explicitly identify the implementation plan and 
projected cost associated with full implementation.
D. Federal Sub-Award Reporting System (FSRS)
    This award may be subject to the Transparency Act sub-award and 
executive compensation reporting requirements of 2 CFR part 170.
    The Transparency Act requires the OMB to establish a single 
searchable database, accessible to the public, with information on 
financial assistance awards made by Federal agencies. The Transparency 
Act also includes a requirement for recipients of Federal awards 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 Awardees of Federal 
Financial Assistance (FFA)
    The recipient must administer the project in compliance with 
Federal civil rights laws, where applicable, that prohibit 
discrimination on the basis of race, color, national origin, 
disability, age, and comply with applicable conscience protections. The 
recipient must comply with applicable laws that prohibit discrimination 
on the basis of sex, which includes discrimination on the basis of 
gender identity, sexual orientation, and pregnancy. Compliance with 
these laws requires taking reasonable steps to provide meaningful 
access to persons with limited English proficiency and providing 
programs that are accessible to and usable by persons with 
disabilities. The HHS Office for Civil Rights provides guidance on 
complying with civil rights laws enforced by HHS. 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

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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.
     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.
F. Federal Awardee Performance and Integrity Information System 
(FAPIIS)
    The IHS is required to review and consider any information about 
the applicant that is in the 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 million 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: Marsha Brookins, 
Director, 5600 Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, 
(Include ``Mandatory Grant Disclosures'' in subject line), Office: 
(301) 443-5204, Fax: (301) 594-0899, Email: [email protected].
    and
    U.S. Department of Health and Human Services, Office of Inspector 
General, ATTN: Mandatory Grant Disclosures, Intake Coordinator, 330 
Independence Avenue SW, Cohen Building, Room 5527, Washington, DC 
20201, URL: https://oig.hhs.gov/fraud/report-fraud/, (Include 
``Mandatory Grant Disclosures'' in subject line,), Fax: (202) 205-0604 
(Include ``Mandatory Grant Disclosures'' in subject line) or Email:  
[email protected].
    Failure to make required disclosures can result in any of the 
remedies described in 45 CFR 75.371. Remedies for noncompliance, 
including suspension or debarment (see 2 CFR part 180 and 2 CFR part 
376).

VII. Agency Contacts

    1. Questions on the programmatic issues may be directed to: Donna 
E. Enfield, Public Health Advisor, Office of Clinical and Preventive 
Services, 5600 Fishers Lane, Mail Stop: 08N34A, Rockville, MD 20857, 
Phone: (301) 526-6966, Fax: (301) 594-6213, Email: [email protected].
    2. Questions on grants management and fiscal matters may be 
directed to: Indian Health Service, Division of Grants Management, 5600 
Fishers Lane, Mail Stop: 09E70, Rockville, MD 20857, Email: 
[email protected].
    3. For technical assistance with Grants.gov, please contact the 
Grants.gov help desk at (800) 518-4726, or by email at 
[email protected].
    4. For technical assistance with GrantSolutions, please contact the 
GrantSolutions help desk at (866) 577-0771, or by email at 
[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.

Roselyn Tso,
Director, Indian Health Service.
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