Grants and Cooperative Agreements; Availability, etc.: Managed Care Impact on People With Significant Physical and Mental Disabilities

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

Grants and Cooperative Agreements; Availability, etc.: Managed

Care Impact on People With Significant Physical and Mental Disabilities

AGENCY: Office of the Assistant Secretary for Planning and Evaluation

(ASPE), Department of Health and Human Services (HHS).

ACTION: Request for applications to conduct research to better

understand the impact of managed care on people with significant

physical and mental disabilities. Projects will analyze existing data

sets to explore issues of utilization, access, quality, costs and

outcomes for people with disabilities in managed care systems. In

addition, where possible proposed applications shall capitalize on

linking state and local data sets containing data on functioning and

health status for disabled individuals to utilization and cost data.

For purposes of applications requested under this announcement,

``individuals with disabilities'' includes those under the age of 64

with ongoing conditions or chronic illnesses of such severity that they

result in a need for extra or specialized health services or assistance

with daily living tasks. Specific groups of disabled individuals

included in this definition are children and working aged adults 18-65

with physical disabilities, mental retardation, developmental

disabilities and persistent mental illness.

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SUMMARY: The primary goal of this grant announcement is to support

research which employs the analysis of existing data and experience to

inform policies related to disability and managed health care. Data

sets which permit the Department to compare the service use,

expenditures and outcomes of children and working age adults (18-64)

with disabilities in managed care with similar persons in the fee-for-

service system or that allow for an assessment of utilization and costs

prior to and following managed care enrollment are of particular

interest. Such data sets could include information from: Medicaid

management information systems; community provider networks including

community health centers; private insurers and health plans; employers;

social security records; hospital records and other accessible data

sets which contain relevant analytical variables. These projects are

intended to foster new analyses of existing data sources by encouraging

the use of data sets from states, local areas, or facilities in order

to address issues of quality, cost, access and outcomes. We estimate

that the scope and level of effort will require from 12 to 24 months to

accomplish.

DATES: The closing date for submitting applications under this

announcement is July 14, 1995.

ADDRESSES: Send application to Grants Officer, Office of the Assistant

Secretary for Planning and Evaluation, Department of Health and Human

Services, ASPE/IO, 200 Independence Avenue, SW., Room 405F, Hubert H.

Humphrey Building, Washington, DC 20201. Attention: Albert A. Cutino,

Grants Officer.

FOR FURTHER INFORMATION CONTACT:

Application Instructions and Forms should be requested from and

submitted to: Grants Officer, Department of Health and Human Services,

ASPE/IO, 200 Independence Avenue, SW., Room 405F, Hubert H. Humphrey

Building, Washington, DC 20201, Telephone: (202) 690-8794. Requests for

Forms will be accepted and responded to up to 30 days prior to closing

date of receipt of Applications. Technical questions should be directed

to Andreas Frank or Kevin Hennessy, ASPE/IO, Telephone (202) 690-6443

or (202) 690-7272. Questions also may be faxed to (202) 401-7733.

Written technical questions should be addressed to Dr. Hennessy or Mr.

Frank at the above address. (Application submissions may not be faxed.)

ELIGIBLE APPLICANTS: The Department seeks applications from

universities, post-secondary degree granting entities, managed care

organizations, private employers and insurers, and other independent

researchers. (For-profit organizations are advised that no grant funds

may be paid as profit to any recipient of a grant or subgrant.) Profit

is any amount in excess of allowable direct and indirect costs of the

grantee.

SUPPLEMENTARY INFORMATION:

Part I

Legislative Authority

This cooperative agreement is authorized by Section 1110 of the

Social Security Act (42 U.S.C. 1310) and awards will be made from funds

appropriated under Public Law 103-112 (DHHS Appropriations Act for FY

1995).

Project History and Purpose

Rising health care expenditures have attracted considerable

attention and concern over the past decade. Of particular concern to

state and federal governments, Medicaid spending had increased from $41

billion in 1985 to $138 billion by 1994. In an effort to control

spiraling Medicaid costs, states are increasingly turning to managed

care, with estimates that approximately 25% of current Medicaid

recipients are covered by a form of managed care, although

participation remains concentrated in a relatively few states. With the

demise of national health care reform this trend is expected to

accelerate.

Over 93% of Medicaid payments are now made on a fee-for-service

basis. Why is such a small proportion of Medicaid payments affected by

the movement to managed care? An important reason is that about 70% of

Medicaid expenditures goes to support the health care of the disabled

and for long term care--neither of which is included in state managed

care arrangements to any great extent.

Although research on the impact of managed care is still relatively

new, studies of the public sector suggest that costs savings can be

achieved without significant compromising quality. To beleaguered

states trying to find ways to tame their Medicaid budget, the desire to

incorporate their disabled and long term care populations under managed

care is understandable. [[Page 25922]]

In theory, managed care should have significant potential for

improving services to people with disabilities including: (1) Increased

flexibility to design treatment programs tailored to their special

needs; (2) more resources for preventative services and care

management/coordination; and (3) lower out-of-pocket burdens. However,

people with disabilities are concerned that overemphasis on cost

reduction may overshadow the potentially positive benefits of managed

care. They worry that the financial incentives resulting from a

capitation system will result in reduced access to needed services, and

that those providers with specialized expertise in disability may be

discouraged from participating in managed care arrangements.

State interest in incorporating disabled persons into Medicaid

managed care systems--either through 1915(b) or 1115 waiver

authorities--has grown dramatically in recent years. Currently, Oregon,

Florida, Tennessee and Arizona have approved 1115 waivers that enroll

one or more segments of their disabled population into managed care.

Another 16 states have received freedom of choice waivers (1915b) under

which they have mandated enrollment of certain segments of the SSI

disabled population into managed care. However, most of these 1915(b)

efforts involve primary care cases management (PCCM) rather than

capitation and the assumption of financial risk.

The greatest momentum toward managed care remains in the private

sector. Among employer-based plans, and rapid increase in enrollment in

managed care plans is well documented. Along with this general trend is

a series of developments which directly links private sector managed

care arrangements to populations with special needs e.g., the

development of subacute care in hospitals and skilled nursing

facilities; the development of contracts between providers of

rehabilitation services and employer-based health plans; new forms of

home health care for high risk populations, carve-outs for managed

behavioral health services (including alcohol and substance abuse

services).

In short, the movement toward managed care in the public and

private sectors is an important and continuing trend that is likely to

have a significant impact on people with disabilities. Yet the

development of a knowledge base that is available to state and federal

policy makers, insurers and health plans, and consumers to facilitate

informed decision-making about managed care and disability has barely

begun. A variety of critical questions demand answers. For example:

How well does managed care serve people with disabilities

in comparison to the fee-for-service system?

What health care and related services do people with

disabilities need?

How should quality and effectiveness of care for people

with disabilities be measured?

How can financial incentives be created for health plans

to adequately serve people with disabilities?

How can capitation payments be developed which reflect the

service use patterns of disabled populations?

What are the most effective ways of managing the care of

special needs populations?

It is essential that careful attention is directed to adequately

addressing these and other important questions, especially at a time in

which federal, state, and private insurers have strong incentives to

enroll disabled populations into managed care.

To develop information which evaluates the impact of managed care

on persons with disabilities and supports the development of approaches

which efficiently and effectively respond to their needs, the Office of

the Assistant Secretary for Planning and Evaluation has developed a

broad-based research plan. This plan includes the following components:

1. Studies which track the service use, cost and outcomes of non-

elderly SSI recipients enrolled in managed care under state-wide

Medicaid 1115 health reform demonstrations.

2. Studies of the experiences of disabled populations enrolled in

large, privately insured, employer-based managed care plans.

3. Studies which document the best practices of innovative public

and private managed care plans that serve people with disabilities.

4. A program of grants to encourage experts in a variety of

settings to identify and analyze existing data sets which can inform

the development of managed care policies and practices which are

responsive to special needs populations.

This grant announcement encompasses the fourth component of the

above research strategy.

Available Funds

1. The Assistant Secretary has available $800,000 for awards in the

$50,000 to $150,000 range.

2. We will consider application over $150,000, but should be

submitted as a separate additional application(s).

3. Nothing in this application should be construed as committing

the Assistant Secretary to dividing available funds among all qualified

applicants or to make any award. The selection of the final awards will

be determined by the Assistant Secretary on the basis of the

availability of funds, the criteria in Part III of this announcement,

and coverage of the Policy Research Area(s) in Part II of this

announcement.

Period of Performance

Award(s) pursuant to this announcement will be made on or about

September 1, 1995.

Part II. Policy Research Areas

Research conducted under grants awarded through this announcement

should be addressed to research questions related to a combination of

the following topics: (a) defining and measuring disability in health

care system, (b) analyzing the impact of managed care on access to

health care services, service use patterns and expenditures, (c)

assessing the impact of managed care on individual outcomes and other

quality indicators, (d) financing and reimbursement incentives which

encourage/impede participation in managed care, and (e) organization of

the delivery system for disabled populations enrolled in managed care.

A. Definition and Measurement of Disability

In principle, the movement of both Medicaid programs and large

employers to managed care delivery systems affords an opportunity to

study the impact of managed care on large numbers of disabled

individuals. The difficulty is in determining ways to identify such

persons so that their experience can be tracked and compared to others

without disabilities and with similarly disabled persons in the fee-

for-service system. Further complicating this problem is the often

large variation in service use patterns of people with similar

disabling conditions.

The goals of this research area are to encourage exploration of

alternative approaches to defining and measuring disability and to

examine the results of these measures in health care settings. ASPE is

particularly interested in the health care experience of children and

working age adults with significant disability including persons with

physical disabilities, the MR/DD population, and persons with serious

mental illness. Questions of interest include:

What measures or indicators can be used to group people

with disabilities in ways that are clinically meaningful? How can these

measures be applied to [[Page 25923]] managed care settings? What are

the strengths and limitations of such measures and how does this effect

their potential usefulness?

What conditions, health care consumption patterns or other

indicators are particularly good markers of severe disability in

working age adults and in children?

How do managed care providers identify high-risk people

with special care needs who may require intensive care management?

What do we know about the prevalence and participation of

various groups of disabled persons in both public and private managed

care arrangements? What are the characteristics of enrollees vs. those

enrolled in fee-for-service, including the nature and severity of their

conditions?

B. Impact on Access, Service Use, and Expenditures

Some aspects of managed care have the potential to be more

advantageous than traditional fee-for-service arrangements for people

with disabilities. Managed care plans can ensure providers more

discretion than the traditional fee-for-service system in allocating

resources. Theoretically, the ability to access a more comprehensive

range of services and providers can enhance continuity of care,

coordination, and appropriateness of services provided. However, many

aspects of managed care are potentially disadvantageous to people with

disabilities. The major concern is that more emphasis on cost savings

will translate into greater risk for less care or inappropriate care

for the most vulnerable populations.

Cost-effectiveness remains a critical feature of managed care in

that it claims to achieve measurable cost savings for people with

disabilities through better care management and the substitution of

lower for higher cost services. Unfortunately, there are few data to

inform either public payers or health plans about whether such cost

savings can be realized. Within this issue area, the following types of

questions are pertinent:

Access and Service Use

What types of health benefits and related services do

people with disabilities receive in current managed care systems? What

variables best explain variation in service use? How does service use

vary among the most prevalent disabling conditions? by indicators of

functioning?

How does managed care affect health service utilization

patterns when compared to fee-for-service? To what extent do people

with disabilities enrolled in managed care systems have improved access

to benefits, services and/or more flexible services delivery patterns?

Is there any evidence of substitution of certain services

as a result of managed care practices (e.g. preventive care and

rehabilitation for other services such as in-patient care and emergency

room services)?

To what extent do managed care plans favor physician and

hospital services over home health care and rehabilitation services?

How does access to services by disabled enrollees in

managed care vary by payment source, type of managed care plan and

severity of disabling condition?

Public and Private Health Care Expenditures

What are the health care expenditures of people with

disabilities in managed care arrangements and how do they compare to

the fee-for-service system? How do these expenditures vary according to

source of payment, disabling condition, level of functioning/need, date

of onset of disabling condition?

What factors most contribute to the costs of health care

for the disabled? Which are most susceptible to modification?

Are there cost savings associated with managed care use

for disabled persons and how are they achieved? Are some types of

managed care plans more effective than others in realizing cost

savings?

What impact does managed care have on total, out of pocket

and per capita expenditures for disabled populations, and how does this

vary among different disabled groups (i.e., mentally ill, mentally

retarded/developmentally disabled, physically disabled, children,

adults)?

How do different cost sharing arrangements under managed

care impact on access and utilization for people with disabilities?

Is there any evidence that managed care plans serving

people with disabilities in either the public or private sector shift

costs to open ended payment systems such as Medicaid institutional and

community based services and programs, state funded programs and

community hospitals?

How do financing sources such as private insurance,

Medicaid, workman's compensation and short-term disability insurance

interest with one another in financing services for disabled

populations enrolled in managed care?

C. Quality and Outcomes

A fundamental question for the disability community and for state

and federal policy makers is whether managed health care provides

quality services and produces satisfactory outcomes for people with

special health care needs. To address this question requires an

understanding of what the basic health care needs of the disabled

actually are and what services in what amounts are more or less

effective in meeting these needs.

Of particular importance in addressing the above issue is finding

outcome measures which can be applied to populations whose

characteristics and needs are quite distinct from one another. For

example, the needs of people with physical disabilities are likely to

be markedly different than persons with chronic mental illness. One

approach to this issue is to examine the impact of health services on

the functioning of people with chronic health care conditions.

Questions in this research area include:

Quality

What disability-specific performance measures do managed

care plans employ to assess how well they are doing with special needs

populations, and what are the results of applying these measures? Are

there satisfaction measures that specifically address the concerns of

disabled individuals, and how do they compare to measurement of

satisfaction in non-disabled populations?

How do states monitor the performance of managed care

arrangements in which they enroll significant numbers of disabled

persons and how does such monitoring affect the quality of services for

disabled beneficiaries?

Outcomes of Disabled in Managed Care

What measures are the most useful in predicting outcomes

for people with disabilities in managed care? To what extent should

they be condition specific or specific to a particular disabled

category? Can these outcomes be linked to the presence/absence of

specific services and treatments? If so, what measures of performance

are created and how well do managed care plans rate on such measures?

To what extent can their performance be compared with the fee-for-

service system?

What impact does managed care have on level of functioning

of persons with disabilities? Is this a good measure of quality of care

received?

How does managed care plans compare to fee-for-service

plans [[Page 25924]] compare in areas of mortality and morbidity,

enrollment and disenrollment, and satisfaction, for comparably-disabled

populations? Are some types of managed care plans better performers

than others (e.g., specialized programs vs. plans where the disabled

are a small subset of enrollees, PPOs vs. HMOs)? Are sub-populations of

the disabled community better or worse off under managed care (i.e.

children with functional impairments, adults with cognitive and mental

impairments, adults with significant physical disabilities)?

D. Financing and Reimbursement

Financial incentives which would encourage health plans and

providers to include people with significant disabilities in managed

care are largely lack in today's system. In the absence of such

incentives, managed care plans can improve their financial results by

selecting ``good risks'' while avoiding bad ones.

Providers who encourage the enrollment of disabled individuals in

plans that are fully capitated face significant challenges. First,

there is little empirical basis for predicting the added costs (if any)

of serving a population with disabilities. To the extent that a managed

care plan or provider does try to cover more high risk populations in

private plans, premium rates must be adjusted or the plan could end up

losing money. However, if premium rates are adjusted too high, more

health participants will opt out of the plan. Within this issue area,

the following types of questions are pertinent:

How are capitation rates sets for health plans enrolling

significant numbers of people with disabilities? How and to what extent

are disability characteristics taken into account in setting such

rates? How well do the rates work for all interested parties?

How do different risk sharing mechanisms affect the

willingness/capacity of the managed care plan to enroll disabled

populations and insure access to a broader range of services for

disabled populations (e.g., risk pools, reinsurance, sharing costs with

other payers, etc.)?

What are the advantages and disadvantages of various risk

sharing arrangements? How do various arrangements affect service use

patterns and outcomes of care?

What are some of the more promising strategies, or

insurance market reforms, to offset the incentives of managed care

plans to select out potentially high risk persons?

E. Organization of the Delivery System

Greater attention is necessary to determine how managed care plans

should be organized to address the needs of people with disabilities.

Whether plans which specialize in disability will work better than

plans which include the disabled in a larger, healthier population of

enrollees is not clear. Another key design issue in organizing managed

care systems for people with disabilities is the extent to which and

how long term care services should be integrated/coordinated with acute

care services, given that people with significant disabilities may need

access to both. The incentives created by leaving one system open-ended

while the other is capped are obvious. In addition, there are a variety

of models of managed care, and it remains unclear whether some are

better than others in providing beneficiaries with good quality

services without exposing the plan to unacceptable financial risk.

While this issue area, the following types of questions are pertinent:

What are the advantages and disadvantages of specialized

managed care plans which only serve the disabled compared with general

plans which incorporate the disabled in a larger population of

healthier persons in terms of benefits and costs?

Which managed care models (e.g., staff and group HMOs,

PPOs, open panel HMOs) are more (or less) effective in serving people

with special needs and to the extent they are more effective. how do

they do it?

What differences are there in outcomes and consumer

satisfaction when services are integrated vertically versus through

networking strategies?

To what extent do managed care plans serving people with

disabilities coordinate their benefits with the long term care system?

What non-financial incentives are important to encouraging

health plans to offer more comprehensive services to people with

disabilities?

How do managed care plans manage care for those people

consuming the most services?

F. Requirement of All Potential Grantees

Part of the resultant grant, we requiring that grantees commit

participate in a one-day meeting in Washington with a Technical

Advisory Group. All applicants will be required to attend a Technical

Advisory Group (TAG) meeting upon completion of the two year grant

award cycle, regardless of the fact that some awards may be completed

prior to two years. The TAG, comprised of experts on disability and

managed care, will integrate the various components of the ASPE

research strategy described in Section II. The Government will to pay

for travel to and from Washington for this TAG regardless of whether

the grant period has ended or remains in effect.

Part III. Application Preparation and Evaluation Criteria

This part contains information on the preparation of an application

for submission under this announcement, the forms necessary for

submission and the evaluation criteria under which the applications

will be reviewed. Potential applicants should read this part carefully

in conjunction with the information and questions provided in Part II.

Applications should be assembled as follows:

1. Abstract: Provide a one-page summary of the proposed project.

2. Goals, Objectives, and Usefulness of Project: Include an

overview which describes the need for the proposed project; indicates

the background and policy significance of the issue area(s) to be

researched including a critique of related disability specific studies;

outlines the specific quantitative and qualitative questions to be

investigated; and describes how the proposed project will advance

scientific knowledge and policy development on the impact of managed

care on people with disabilities.

3. Methodology and Design: Provide a description and justification

of how the proposed research project will be implemented, including

methodologies, approach to be taken, data sources to be used, and

proposed research and analytic plans. Identify any theoretical or

empirical basis for the methodology and approach proposed. In addition,

provide evidence of access to data set(s) proposed to be studied.

Proposals, where data sets permit, should address the areas

highlighted in Section II as well as the following quantitative and

qualitative issues:

Utilization of services--both volume and mix of services;

Tracer measures of specific conditions (e.g., readmission

for mental diagnosis, prophylactic treatment for AIDS cases, use of

rehabilitative services);

Selection bias;

Enrollment trends of disabled individuals in managed car

organizations, including reasons for disenrollment;

Outcome analyses such as mortality rates, use of emergency

services, changes in functional status, satisfaction information, and

hospital readmissions; [[Page 25925]]

Overall health care expenditures by disabled groups;

Cost savings practice patterns (e.g., referrals to cost-

effective providers, specialized case management practices, provider

discounted fees, concurrent utilization review practices);

Access to specialty care;

Benefit package (e.g., long-term rehabilitation services,

durable medical equipment);

Availability of specialty providers;

Coordination with auxiliary services;

Risk sharing mechanisms;

Risk adjustment and capitation rate development;

Coordination and integration of services.

4. Experience of Personnel/Organizational Capacity: Briefly

describe the applicant's organizational capabilities and experience in

conducting pertinent research projects. Identify the key staff who are

expected to carry out the research project and provide a curriculum

vitae for each person. Provide a discussion of how key staff will

contribute to the success of the project.

5. Budget: Submit a request for Federal funds using Standard Form

424A and provide a proposed budget using the categories listed on this

form.

Review Process and Funding Information

A panel of at least three independent experts will review and score

all applications that are submitted by the deadline date and which meet

the screening criteria (all information and documents as required by

this Announcement.) The panel will review the applications using the

evaluation criteria listed below to score each application. These

evaluation criteria will be the primary elements used by the ASPE in

making funding decisions.

HHS reserves the option to discuss applications with other Federal

agencies, Central or Regional Office staff, specialists, experts,

States and the general public. Comments from these sources, along with

those of the independent experts, may be considered in making an award

decision.

State Single Point of Contact (E.O. No. 12372)

The Department of Health and Human Services has determined that

this program is not subject to Executive Order No. 12372,

Intergovernmental Review of Federal Programs, because it is a program

that is national in scope and the only impact on State and local

governments would be through subgrants. Applicants are not required to

seek intergovernmental review of their applications with the

constraints of E.O. No. 12372.

Deadline for Submission of Application

The closing date for submission of applications under this

announcement is July 14, 1995. Applications must be postmarked or hand-

delivered to the application receipt point no later than 4:30 p.m. on

July 14, 1995.

Hand-delivered applications will be accepted Monday through Friday

prior to and on July 14, 1995. During the hours of 9:00 a.m. to 4:30

p.m. in the lobby of the Hubert H. Humphrey building located at 200

Independence Avenue, SW., in Washington, DC. When hand-delivering an

application, call 690-8794 from the lobby for pick-up. A staff person

will be available to receive applications.

An application will be considered as meeting the deadline if it is

either: (1) Received at, or hand-delivered to, the mailing address on

or before July 14, 1995, or (2) on the closing date of receipt from

applications and received in time to be considered during the

competitive review process (within two weeks of the deadline date).

When mailing application packages, applicants are strongly advised

to obtain a legibly dated receipt from a commercial carrier (such as

UPS, Federal Express, etc.), or from the U.S. Postal Service as proof

of mailing by the deadline date. If there is a question as to when an

application was mailed, applicants will be asked to provide proof of

mailing by the deadline date. When proof is not provided, an

application will not be considered for funding. Private metered

postmarks are not acceptable as proof of timely mailing.

Applications which do not meet the July 14, 1995 deadline are

considered late applications and will not be considered or reviewed in

the current competition. HHS will send a letter to this effect to each

late applicant.

HHS reserves the right to extend the deadline for all applications

due to acts of God, such as floods, hurricanes or earthquakes; due to

acts of war; if there is widespread disruption of the mail; or if HHS

determines a deadline extension to be in the best interest of the

Government. However, HHS will not waive or extend the deadline for any

applicant unless the deadline is waived or extended for all applicants.

Applications Forms

See section entitled ``Components of a Complete Application.'' All

of these documents must accompany the application package.

Length of Application

Applications should be as brief and concise as possible, but assure

successful communication of the applicant's proposal to the reviewers.

In no case shall an application (excluding the resume appendix and

other appropriate attachments) be longer than 30 single spaced pages;

it should neither be unduly elaborate nor contain voluminous supporting

documentation.

Selection Process and Evaluation Criteria

Selection of the successful applicant(s) will be based on the

technical criteria laid out in this announcement. Reviewers will

determine the strengths and weaknesses of each application in terms of

the evaluation criteria listed below, provide comments and assign

numerical scores. The review panel will prepare a summary of all

applicant scores and strengths/weaknesses and recommendations and

submit it to the ASPE for final decisions on award(s).

The point value following each criterion heading indicates the

maximum numerical weight that each section will be given in the review

process. An unacceptable rating on any individual criterion may render

the application unacceptable. Consequently, applicants should take care

to ensure that all criteria are fully addressed in the applications.

Applications will be reviewed as follows:

Applications will be initially screened for compliance with the

timeliness and completeness. If judged in compliance, the application

then will be reviewed by government personnel, augmented by outside

experts where appropriate. Three (3) copies of each application are

required. Applicants are encouraged to send an additional three (3)

copies of their application to ease processing, but applicants will not

be penalized if these extra copies are not included. The length of the

application is limited to 30 single spaced pages; extraneous materials

such as videotapes and brochures should not be included and will not be

reviewed.

Evaluation criteria

1. Goals, Objectives, and Potential Usefulness of the Quantitative

and Qualitative Analyses (30 points). The potential usefulness of the

objectives and how the anticipated results of the proposed project will

advance scientific knowledge and policy development on the impact of

managed care on disabled populations.

2. Methodology and Design (35 points). The appropriateness,

[[Page 25926]] soundness, and cost-effectiveness of the methodology,

including research design, statistical techniques, analytical

strategies, degree of inclusion of utilization, cost and functional

data and information, innovative and creative selection of existing

data sets, and other procedures. The applicant is encouraged to

specifically address how they intend, when applicable, to examine the

quantitative and qualitative areas previously outlined.

3. Experience and Qualifications of Personnel (35 points). The

qualifications and experience of the project personnel for conducting

the proposed research and indications of innovative approaches and

creative potential

Reports

The grantee must submit annual progress reports and a final report.

The specific format and content for these reports will be provided by

the project officer.

Disposition of Applications

1. Approval, disapproval, or deferral. On the basis of the review

of an application, the ASPE will either (a) approve the application in

whole, as revised, or in part for such amount of funds and subject to

such conditions as are deemed necessary or desirable for the research

project; (b) disapprove the application; or (c) defer action on the

application for such reasons as lack of funds or a need for further

review.

2. Notification of disposition. The ASPE will notify the applicants

of the disposition of their application. A signed notification of award

will be issued to notify the applicant of the approved application.

Components of a Complete Application

A complete application consists of the following items in this

order:

1. Application for Federal Assistance (Standard Form 424, Revised

4-88);

2. Budget Information--Non-construction Programs (Standard Form

424A, Revised 4-88);

3. Assurances--Non-construction Programs (Standard Form 424B,

Revised 4-88);

4. Table Contents;

5. Budget Justification for Section B--Budget Categories;

6. Proof of non-profit status, if appropriate;

7. Copy of the applicant's approved indirect cost rate agreement if

necessary;

8. Project Narrative Statement, organized in five sections

addressing the following topics;

(a) Understanding of the Effort,

(b) Project Approach,

(c) Staffing Utilization, Staff Background, and Experience,

(d) Organizational Experience, and

(e) Budget Narrative;

9. Any appendices/attachments;

10. Certification Regarding Drug-Free Workplace;

11. Certification Regarding Debarment, Suspension and Other

Responsibility Matters; and

12. Certification and, if necessary, Disclosure Regarding Lobbying;

13. Application for Federal Assistance Checklist.

Dated: May 3, 1995.

David T. Ellwood,

Assistant Secretary for Planning and Evaluation.

[FR Doc. 95-11832 Filed 5-12-95; 8:45 am]

BILLING CODE 4151-04-M