Healthy Start InitiativeSpecial Project Grants

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

[PN 2202]

RIN 0905-ZA14

Healthy Start Initiative--Special Project Grants

AGENCY: Health Resources and Services Administration (HRSA), PHS.

ACTION: Notice of availability of funds.

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SUMMARY: The Health Resources and Services Administration (HRSA)

announces the availability of fiscal year 1994 funds for an open

competition for Healthy Start Initiative--Special Projects grants (HSI-

SP). The purpose of the HSI-SP is to expand the Healthy Start

Initiative to include community-based programs that will significantly

reduce infant mortality through the development and implementation of

special targeted interventions. Competition is open to rural and urban

community-based programs that are developing and implementing

innovative strategies for the purpose of reducing infant mortality.

Awards will be made by the Maternal and Child Health Bureau under the

program authority of Section 301 of the Public Health Service Act.

Funds for the HSI-SP Grants were appropriated under Public Law 103-112.

Up to $4,000,000 is available for four projects at up to $1,000,000 per

year, renewable for a second year, subject to funds availability.

The PHS is committed to achieving the health promotion and disease

prevention objectives of Healthy People 2000, a PHS led national

activity for setting priority areas. The HSI-SP grant program will

directly address the Healthy People 2000 objectives related to maternal

and infant health, and especially health status objective 14.1, to

reduce the infant mortality rate to no more than 7 per 1000 live

births. Potential applicants may obtain a copy of Healthy People 2000

(Full Report: Stock No. 017-001-00474-0) or Healthy People 2000

(Summary Report: Stock No. 017-001-00473-1) through the Superintendent

of Documents, Government Printing Office, Washington, DC 20402-9325

(telephone 202 783-3238).

ADDRESSES: Grant applications (Revised PHS form 5161-1, approved under

OMB clearance number 0937-0189) and guidance for applicants must be

obtained from, and applications submitted to: Grants Management Branch,

Maternal and Child Health Bureau, HRSA, room 18-12, Parklawn Building,

5600 Fishers Lane, Rockville, Maryland 20857, telephone 301 443-1440.

DATES: The application deadline date is May 23, 1994. Applications will

be considered to be on time if they are either: (1) Received on or

before the deadline date, or (2) postmarked on or before the deadline

date and received in time for orderly processing. Applicants should

request a legibly dated receipt from a commercial carrier or the U.S.

Postal Service, or obtain a legibly dated U.S. Postal Service postmark.

Private metered postmarks will not be accepted as proof of timely

mailing. Late applications or those sent to an address other than

specified in the ADDRESS section will be returned to the applicant.

FOR FURTHER INFORMATION contact: Requests for technical or programmatic

information should be directed to Thurma McCann, M.D., M.P.H.,

Director, Division of Healthy Start, Maternal and Child Health Bureau,

HRSA, 12300 Twinbrook Parkway, Suite 200, Rockville, Maryland 20852,

telephone 301 443-0543. Requests for information concerning

administration and business management issues should be directed to

Jeanne Conley, Grants Management Specialist, at the address listed in

the ADDRESS section above.

SUPPLEMENTARY INFORMATION:

Program Background and Objectives

The specific goal of the Healthy Start Initiative--Special Projects

is to significantly reduce in two years high infant mortality rates in

rural or urban designated project areas through accelerated

implemention of innovative strategies. Therefore, it is expected that

the programs will incorporate the principles of innovation, community

commitment, and personal responsibility and, in doing so, improve

access to care. To accomplish this goal, prospective applicants must

have an established consortium which has a minimum of two years

experience with planning and implementation of infant mortality

strategies, including an extensive public information campaign. In

addition, applicants must have the capacity and willingness to develop

a management information system to track project interventions and to

participate in an extensive national evaluation with currently funded

Healthy Start projects.

Finally, Federal Healthy Start Initiative--Special Projects grant

funds may only be used to supplement, and not to supplant or replace,

either existing State or local funds, or State or local funds that

would otherwise be made available to the project.

Eligible Project Areas

Areas targeted under the Healthy Start Initiative--Special Projects

are those in which infant mortality problems are most severe, resources

can be concentrated, implementation is manageable, and progress can be

measured. A project area is defined as one which is composed of one or

more contiguous geographic areas or neighborhoods for which

improvements have been planned and are being implemented with the

principles of: Innovation, community commitment and involvement,

increased access, service integration, and personal responsibility.

Project areas must represent a reasonable and logical catchment area in

which a consortium for delivering services is already operational, and

for which infant mortality reduction strategies are already designed.

To be eligible for funding under the HSI-SP, a project area must

have at least 50 but no more than 200 infant deaths per year, and must

have an average infant mortality rate of at least 14.5 deaths per 1000

live births, from vital statistics data, for the 3-year period 1988-

1990. The minimum of fifty infant deaths per year is meant to assure

selection of communities with a sufficient magnitude of the problem to

justify concentrating resources to reduce infant mortality. The upper

limit of 200 infant deaths per year is meant to assure projects of a

manageable size. The eligibility thresholds are identical for urban and

rural areas.

Eligible Applicants

Eligible applicants are public or nonprofit private organizations,

and tribal organizations, applying on behalf of an existing community-

based consortium. Applications must be approved by the chief elected

official of the city or county in which the project area is located

(or, if there is more than one such entity, the chief elected officials

acting in concert), or by the tribal leadership of the tribe or tribal

organization which has jurisdiction over the project area. No more than

one application may be made for a given project area.

The 15 entities that are currently receiving Healthy Start

Initiative funds are not eligible for Special Project grants.

Review Criteria

Applications for grants will be reviewed and evaluated according to

the following criteria:

1. Existence of an operational consortium that includes appropriate

representation of project area providers and consumers.

2. The effectiveness of the consortium's activities over the

previous two years, as demonstrated by implemented strategies to reduce

infant mortality.

3. The extent to which the applicant's proposed activities appear

feasible and likely to achieve the project's goals and objectives

within the two year project period.

4. Demonstrated ability to maximize and coordinate existing

resources and acquire additional resources.

5. Substantial involvement of the State and local Maternal and

Child Health and other agencies.

6. Demonstrated ability to effectively manage the project's fiscal

resources.

7. Demonstrated leadership capability in achieving project goals

and objectives in the last two years.

8. Reasonableness of the proposed budget.

9. Other factors which the Secretary determines will increase the

potential of the project to significantly reduce the rate of infant

mortality in the project area.

Preference and Priorities

Funding preference will be given to an approved applicant who: (1)

Has an operational infant mortality initiative of at least two years

duration; (2) has a strong established community-based consortium that

has identified and begun to address local needs and priorities; and (3)

has demonstrated the ability to generate private sector funding. Within

any group of preferred applicants, priority will be given to applicants

from States that do not already have a funded Healthy Start Initiative

grant. Because of time constraints, public comments on the funding

preference and the funding priority are not being solicited.

Allowable Costs

The Health Resources and Services Administration will support

reasonable and necessary costs of Healthy Start Initiative Special

Project grants within the scope of approved activities. Allowable costs

may include salaries, equipment and supplies, travel, contractual,

consultants, and others, as well as indirect costs. HRSA adheres to

administrative standards reflected in the Code of Federal Regulations

45 CFR part 92 and 45 CFR part 74. All other sources of funding to

support this project must be accurately reflected in the applicant's

budget.

Reporting Requirement

A successful applicant under this notice will submit reports in

accordance with the provisions of the general regulations which apply

under 45 CFR part 74, subpart J, Monitoring and Reporting of Program

Performance, with the exception of State and local governments, to

which 45 CFR part 92, subpart C reporting requirements will apply.

Financial reporting will be required in accordance with 45 CFR part 74,

subpart H, with the exception of State and local governments, to which

45 CFR 92.20 will apply.

Public Health System Reporting Requirements

This program is subject to the Public Health System Reporting

Requirements (approved under OMB No. 0937-0195). Under these

requirements, community-based nongovernmental applicants must prepare

and submit a Public Health System Impact Statement (PHSIS). The PHSIS

is intended to provide information to State and local health officials

to keep them apprised of proposed health services grant applications

submitted by community-based nongovernmental organizations within their

jurisdictions. Community-based non-governmental applicants are required

to submit the following information to the head of the appropriate

State and local health agencies in the area(s) to be impacted no later

than the Federal application receipt due date: (a) A copy of the face

page of the application (SF 424).

(b) A summary of the project (PHSIS), not to exceed one page, which

provides: (1) A description of the population to be served.

(2) A summary of the services to be provided.

(3) A description of the coordination planned with the appropriate

State or local health agencies.

Executive Order 12372

This program has been determined to be a program which is subject

to the provisions of Executive Order 12372 concerning intergovernmental

review of Federal programs by appropriate health planning agencies, as

implemented by 45 CFR part 100. Executive Order 12372 allows States the

option of setting up a system for reviewing applications from within

their States for assistance under certain Federal programs. The

application packages to be made available under this notice will

contain a listing of States which have chosen to set up such a review

system and will provide a single point of contact (SPOC) in the States

for review. Applicants (other than federally-recognized Indian tribal

governments) should contact their State SPOCs as early as possible to

alert them to the prospective applications and receive any necessary

instructions on the State process. For proposed projects serving more

than one State, the applicant is advised to contact the SPOC of each

affected State. The due date for State process recommendations is 60

days after the application deadline for new and competing awards. The

granting agency does not guarantee to ``accommodate or explain'' for

State process recommendations it receives after that date.

The OMB Catalog of Federal Domestic Assistance number is 93.926.

Dated: March 1, 1994.

Ciro V. Sumaya,

Administrator.

[FR Doc. 94-6692 Filed 3-22-94; 8:45 am]

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