Availability of Funds for a Cooperative Agreement To Prevent Cancer in Minority Populations

Introduction

The Office of Minority Health (OMH) of the U.S. Public Health

Service (PHS) announces the availability of Fiscal Year 1995 funds to

support one demonstration cooperative agreement to establish a cancer

prevention project in Philadelphia, Pennsylvania.

The OMH is committed to achieving the health promotion and disease

prevention objectives of ``Healthy People 2000,'' a PHS-led national

activity to reduce morbidity and mortality and improve the quality of

life. This announcement is related to the health status, risk reduction

and services and protection objectives for Health People objective

priority area Number 16, cancer.

Authorizing Legislation

This cooperative agreement is authorized under Section 1707(d)(1)

of the Public Health Service Act, as amended by Public Law 101-527.

Availability of Funds

Approximately $250,000 (direct and indirect costs) will be

available in Fiscal Year 1995 to fund one cooperative agreement.

Support may be requested for a project period not to exceed 3 years.

Continuation awards within the project period will be made on the basis

of satisfactory progress and availability of funds. The funding

estimate may vary and is subject to change.

Background

Since the publication of the Report of the Secretary's Task Force

on Black and Minority Health, the OMH and all PHS agencies have made a

commitment to reduce the excessive burden of disability and death borne

by minority populations in the United States.

Congress has expressed a commitment to providing comprehensive

primary health care services for urban city minorities: Asian

Americans/Pacific Islanders; American Indians/Alaska Natives; Blacks;

and Hispanics, with the objective of reducing the excessive burden of

disability and death within these populations. Congress is concerned

about the increasing rate of cancer among the nation's minority

populations and has expressed particular interest about the high rates

in urban areas such as North Philadelphia. For example, in 1992, of the

173 cases of buccal cavity and pharynx cancer in males in Philadelphia,

Black males had 92, or 53.4% of the cases. In the same year, of the 91

cases of esophagus cancer in Philadelphia's male population, Black

males had 49 of the cases, or 53.8%. Of the 4,090 all cancer sites in

males in Philadelphia, Black men had 1,727, or 35.1%. For all cancer

sites for women, Black women had 2,547 of the 4,702 cases or 32.9%.

The high rates of cancer mortality in Philadelphia for the non-

white population, supports the need to develop and deliver cancer

services to diverse minority populations in order to study ways to

improve mortality rates in urban areas.

Congress has recommended that the Office of Minority Health conduct

a cancer outreach and service program in an urban area, such as

Philadelphia. OMH plans to fund a cancer program in North Philadelphia

to address these concerns.

Applicants should possess the following capabilities:

(1) Has the ability and track record to conduct a comprehensive

needs assessment of the prevalence and impact of cancer on minorities

in North Philadelphia compared to other parts of the city, the county,

the state and the nation.

(2) Has a developed and expanded infrastructure to provide

comprehensive cancer reduction health care services for high risk

minorities who reside in North Philadelphia. Furthermore, the health

care services are aimed at reducing unnecessary morbidity and cancer

mortality rates among targeted low income minority populations of the

service area.

(3) Has a comprehensive cancer care program embracing four

components of care: the medical component, which consists of some

combination of surgical, chemical and/or radiation therapy; the oral

health component, which identifies linkages with the dental community,

particularly minority dentists; the psychological component, in which

the emotional needs of cancer patients are addressed; and the

prevention component, which stresses behavioral changes in smoking and

dietary practices, and education and cancer awareness programs.

(4) Is a teaching hospital in North Philadelphia which focuses on

serving low-income minority populations.

(5) Has developed cancer research component to enhance treatment

modalities and prevention strategies to target minority populations.

(6) Has demonstrated outreach linkages with minority neighborhoods

through cancer screening in the community; and by promoting cancer

prevention at community health fairs, through neighborhood businesses,

and religious organizations.

(7) Has trained healthcare professionals with the work experience

and track record of providing culturally appropriate outreach,

screening and health care to Black, Hispanic, Native American and Asian

populations, including the ability to communicate in a variety of

languages.

Applicant Eligibility

Eligible applicants are public and private non-profit organizations

with demonstrated capability to serve the target population in North

Philadelphia. Only teaching hospitals located in North Philadelphia

should apply.

The community served by the applicant should have a minority

population (Black American and/or Hispanic/Latino) in excess of 60

percent, an unemployment rate exceeding the national average by at

least 25 percent, and a poverty rate at least twice the national

average.

Program Requirements

The cooperative agreement will include substantive involvement of

both the recipient and the Federal Government. At a minimum, the

following expectations are anticipated:

Recipient Responsibilities

(1) The recipient shall conduct a comprehensive needs analysis of

cancer prevalence in the North Philadelphia community and document

cancer rates for various types of cancers, i.e., breast, cervical,

prostrate, lung, skin, oral, etc., in the target area; compare

prevalence to other areas of the county, state and the nation in order

to justify the need, and justify the need to select specific types of

cancer for the study.

(2) The recipient shall design a model for minorities in high risk,

low income, urban communities which is integrated, culturally and

linguistically sensitive community-based cancer outreach program. The

model shall embody the four basic components of care: the medical

component, which consists of some combination of surgical, chemical

and/or radiation therapy; oral health component which includes linkages

[[Page 21367]] with the dental community; the psychological component,

in which the emotional needs of the cancer patients are addressed; and

a prevention component which stresses behavioral changes and cancer

awareness programs. The model shall provide for the treatment of cancer

through early diagnosis and provide continuity of support to patients

from screening through treatment. The model should include a viable

coalition of community organizations, and appropriately utilize them to

assist in the development of the project and accomplish the project

objectives. The model should be a coordinated community approach that

involves formal relations with established community organizations with

high visibility and substantial ingress to the targeted population. The

model shall have the potential for replication in similar communities.

(3) The recipient shall establish formal relations with a coalition

or affiliation of community based organizations and professional

associations to assist in the development and conduct of the project.

Recipient shall also coordinate project activities with state and/or

local health departments as appropriate.

(4) The recipient shall implement and conduct all facets of the

model, including screening, treatment, and other necessary and desired

support and follow-up activities, in the targeted minority community.

All aspects of the project shall be fully operational within 10 months

of the effective date of the cooperative agreement.

(5) The recipient shall evaluate the effects of the project in

terms of numbers of patients screened and the provision of continuity

of support to diagnosed cancer patients and submit a written evaluation

report, within 1 year of the effective date of the cooperative

agreement.

(6) The recipient shall prepare a manual for replicating the model

in other similar communities. Consideration should be given to

replication of the approach for diseases other than cancer.

(7) The recipient shall submit monthly progress reports to the

Project Officer. The recipient shall meet with the Project Officer on

an as-needed basis as determined by the Project Officer.

(8) The recipient shall arrange an annual meeting (for appropriate

government, professional and community officials) to provide briefings

regarding programmatic outcomes, evaluation plans, strategies,

agreements, and to provide expertise regarding the identification of

evolving areas of concern affecting the minority populations targeted

in the project.

(9) The recipient shall assist OMH staff in selecting potential

sites for replicating the model.

OMH Responsibilities

Substantial programmatic involvement is as follows:

(1) OMH shall arrange an initial orientation meeting to: discuss

and finalize a project management plan; clarify roles and

responsibilities of the recipient, collaborating community based

organizations, and OMH and other Federal agency staff participating in

the project; establish clear lines of communication.

(2) OMH shall introduce the project participants to other PHS and

Department of Health and Human Services (DHHS) staff, in particular,

staff of cancer programs at the National Cancer Institute (NCI) and the

Centers for Disease Control and Prevention (CDC), for technical and

programmatic consultation and assistance; and to discuss and review a

workplan.

(3) OMH staff shall provide technical assistance and oversight as

necessary to project staff and consultants for the overall design,

implementation, conduct, and assessment of project activities.

(4) OMH staff shall provide technical assistance to the recipient

in the design, development, and implementation of the evaluation plans

and strategies.

(5) OMH staff shall review and approve all evaluation plans and

strategies prior to implementation.

(6) OMH staff shall assist the recipient in arranging for

consultation, on an as-needed basis, from other Government agencies and

non-governmental organizations such as the American Cancer Society.

(7) OMH staff shall be responsible for the selection of potential

sights for replicating the project.

(8) OMH staff shall facilitate the cooperation of organizations

that have grant programs within the service area. These programs will

include the following: Health Careers Opportunity Program (HCOP),

Centers of Excellence (COE), Minority Community Health Coalition

Demonstration, and Public Housing Primary Care Program. In addition to

these programs, OMH staff will facilitate the cooperation of national

organizations such as: National Medical Association, National Dental

Association, Hispanic Dental Association and Interamerican College of

Physicians and Surgeons.

(9) OMH shall be responsible for the printing and distribution of

the manual for replicating the model in similar communities.

Review of Applications

Applications will be screened upon receipt. Those that are judged

to be incomplete, non-responsive to the announcement or nonconforming

will be returned without comment. Applications judged to be complete,

conforming, and responsive, will be reviewed for technical merit in

accordance with PHS policies.

Applications will be evaluated by Federal reviewers. Applicants are

advised to pay close attention to program guidelines, review criteria,

and the general and supplemental instructions provided in the

application kit.

Contacts

Applications will be prepared on PHS Standard Form 5161-1 (approved

by OMB under control number 0937-0189). Application kits and technical

assistance on business and grants management information may be

obtained from Ms. Carolyn A. Williams, Grants Management Officer,

Office of Minority Health, Rockwall II Building, Suite 1000, 5515

Security Lane, Rockville, Maryland 20852, telephone number (301) 594-

0758. Completed applications are to be submitted to the same address.

For program information, contact Mr. John H. Walker, III, Project

Officer, Office of Minority Health, Rockwall II Building, Suite 1000,

5515 Security Lane, Rockville, MD 20852, telephone number (301) 594-

0769.

Application Deadline

To receive consideration, grant applications must be received by

C.O.B. (30 days from the date of this publication). Applications will

be considered as meeting the deadline if they are either: (1) Received

on or before the deadline date, or (2) sent 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 U.S.

Postal Service. Private metered postmarks will not be accepted as proof

of timely mailing. Applications which do not meet the deadline will be

considered late and will be returned to the applicant.

Provision of Smoke-Free Workplace and Non-Use of Tobacco Products by

Recipients of PHS Grants

PHS strongly encourages all grant and contract recipients to

provide a smoke-free workplace and to promote the nonuse of all tobacco

products. In [[Page 21368]] addition, Public Law 103-227, the Pro-

Children Act of 1994, prohibits smoking in certain facilities (or in

some cases, any portion of a facility) in which regular or routine

education, library, day care, health care or early childhood

development services are provided to children.

State Reviews

Applications are subject to state review as governed by Executive

Order 12372, Intergovernmental Review of Federal Programs. All comments

from a State office must be received by the Office of Minority Health's

Grants Management Officer within 60 days after the application

deadline. Applicants should contact the appropriate State Single Points

of Contact (SPOC) early in the application preparation process. A list

of the SPOCs is enclosed with the application kit material.

Public Health System Reporting Requirements

This program is subject to Public Health Systems Reporting

Requirements. Under these requirements, an applicant involving a

community based nongovernmental organization 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.

Applicants involving community-based nongovernmental organizations

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 applications (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.

There is no Catalog of Federal Domestic Assistance number for this

program since it is a one-time project.

Dated: March 17, 1995.

Clay E. Simpson, Jr.,

Acting Deputy Assistant Secretary for Minority Health.

[FR Doc. 95-10577 Filed 4-28-95; 8:45 am]

BILLLING CODE 4160-17-M