Abandoned Infants Assistance and Temporary Child Care for Children With Disabilities and Crisis Nursuries Programs; Availability of Financial Assistance and Requests for Applications

Federal RegisterJun 18, 1996

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families

[Program Announcement No. CB-96-1]

Abandoned Infants Assistance and Temporary Child Care for

Children With Disabilities and Crisis Nursuries Programs; Availability

of Financial Assistance and Requests for Applications

AGENCY: Administration on Children, Youth and Families (ACYF),

Administration for Children and Families (ACF), Department of Health

and Human Services (DHHS).

ACTION: Announcement of the availability of financial assistance and

request for applications to support demonstration projects under the

Abandoned Infants Assistance Act, as amended, Pub. L. 102-236 (42

U.S.C. 670 note) and the Temporary Child Care for Children With

Disabilities and Crisis Nurseries Act of 1986, as amended, Pub. L. 102-

295 (42 U.S.C. 5117a, 5117b, 5117c).

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SUMMARY: The Children's Bureau (CB) within the Administration on

Children, Youth and Families (ACYF), Administration for Children and

Families (ACF) announces the availability of fiscal year 1996 funds for

competing new discretionary grants under the Abandoned Infants

Assistance (AIA) Program and the Temporary Child Care for Children with

Disabilities and Crisis Nurseries (RC/CN) Program.

Funds from the AIA Program are designed to provide community-based,

comprehensive services to abandoned infants and infants at risk of

abandonment and their families.

Funds from the RC/CN Program are designed to support demonstration

projects to provide temporary child care for children with disabilities

and children with chronic illnesses and crisis nurseries for abuse and

neglected children and children at risk of abuse and neglect.

This announcement contains forms and instructions for submitting an

application.

The closing date and time for RECEIPT of applications is 4:30 p.m.,

eastern time zone, on August 19, 1996. Applications MUST BE RECEIVED BY

4:30 p.m. on that day. Applications received after 4:30 p.m. on that

day will be classified as late. Postmarks and other similar documents

DO NOT establish receipt of an application. Detailed application

submission instructions including the addresses where applications must

be received are found in Part III of this announcement.

ADDRESSES: Mail applications to: Department of Health and Human

Services, Administration for Children and Families, Division of

Discretionary Grants, 370 L'Enfant Promenade, SW., 6th Floor,

Washington, DC 20447, ATTN: ________ (Reference announcement number and

priority area.)

Hand deliver applications during the normal working hours of 8:00

a.m. to 4:30 p.m., Monday through Friday, on or prior to the

established closing date to: Administration for Children and Families,

Division of Discretionary Grants, 6th Floor, ACF Guard Station, 901 D

Street, SW., Washington, DC 20447, ATTN: ________.

FOR FURTHER INFORMATION CONTACT:

The ACYF Operations Center, Technical Assistance Team at 1-800-351-

2293, is available to answer questions regarding application

requirements and to refer you to the appropriate contact person in ACYF

for programmatic questions.

[[Page 30872]]

SUPPLEMENTARY INFORMATION: This program announcement consists of three

parts. Part I provides information on the Children's Bureau and general

information on the application procedures. Part II describes the review

process, additional requirements for the grant applications, the

criteria for the review and evaluation of applications, and the

programmatic priorities for which applications are being requested.

Part III provides information and instructions for the development and

submission of applications.

The forms to be used for submitting an application follow Part III.

Please copy as single-sided forms and use in submitting an application

under this announcement. No additional application materials are

available or needed to submit an application.

Applicants should note that grants to be awarded under this program

announcement are subject to the availability of funds.

Part I--General Information

A. Background

The Administration on Children, Youth and Families (ACYF)

administers national programs for children and youth, works with States

and local communities to develop services which support and strengthen

family life, seeks out joint ventures with the private sector to

enhance the lives of children and their families, and provides

information and other assistance to parents.

The concerns of ACYF extend to all children from birth through

adolescence. Many of the programs administered by the agency focus on

children from low-income families; children and youth in need of foster

care, adoption or other child welfare services; preschool children;

children with disabilities; abused and neglected children; runaway and

homeless youth; and children from American Indian and migrant families.

Within ACYF, the Children's Bureau plans, manages, coordinates and

supports child welfare services programs. It administers the Foster

Care and Adoption Assistance Program, the Child Welfare Services State

Grants Program, the Child Welfare Services Research, Demonstration and

Training Programs, the Independent Living Initiatives Program, the

Adoption Opportunities Program, the Temporary Child Care for Children

With Disabilities and Crisis Nurseries Program, the Abandoned Infants

Assistance Program, the Child Care and Development Block Grant Program,

the State Dependent Care Planning and Development Program and the

Family Preservation and Family Support Program.

The Children's Bureau programs are designed to promote the welfare

of all children, including disabled, homeless, dependent, abused or

neglected children and their families. The programs aid in preventing

and remedying the neglect, abuse and exploitation of children. The

programs also encourage the strengthening of the family unit to help

alleviate the unnecessary separation of children from their families

and reunify families, where possible, when separation has occurred.

B. Statutory Authorities Covered Under This Announcement

The Abandoned Infants Assistance Act of 1988, as amended, Public

Law 102-236, 42 U.S.C. 670. CFDA: 93.551.

Temporary Child Care for Children With Disabilities and Crisis

Nurseries Act of 1986, as amended, Public Law 102-295, 42 U.S.C. 5117a,

5117b, 5117c. CFDA: 93-656.

Part II. The Review Process and Priority Areas

A. Eligible Applicants

Each priority area description contains information about the types

of agencies and organizations which are eligible to apply under that

priority area. Because eligibility varies depending on statutory

provisions, it is critical that the ``Eligible Applicants'' section of

each priority area be reviewed carefully.

Before review, each application will be screened for applicant

organization eligibility as specified under the selected priority area.

Applicants from ineligible organizations will not be considered or

reviewed in the competition, and the applicants will be so informed.

Only agencies and organizations, not individuals, are eligible to

apply under this Announcement. All applications developed jointly by

more than one agency or organization, must identify only one lead

organization and official applicant. Participating agencies and

organizations can be included as co-participants, subgrantees or

subcontractors. For-profit organizations are eligible to participate as

subgrantees or subcontractors with eligible non-profit organizations

under all priority areas.

Any non-profit organization submitting an application must submit

proof of its non-profit status in its application at the time of

submission. The non-profit agency can accomplish this by providing a

copy of the applicant's listing in the Internal Revenue Service's (IRS)

most recent list of tax-exempt organizations described in Section

501(c)(3) of the IRS code or by providing a copy of the current valid

IRS tax exemption certification, or by providing a copy of the articles

of incorporation bearing the seal of the State in which the corporation

or association is domiciled.

B. Review Process and Funding Decisions

Timely applications received by the deadline date which are from

eligible applicants will be reviewed and scored competitively. Experts

in the field, generally persons outside the Federal government, will

use the appropriate evaluation criteria listed later in this section to

review and score the applications. The results of this review are a

primary factor in making funding decisions.

The ACYF reserves the option of discussing applications with, or

referring them to, other Federal or non-Federal funding sources when

this is in the best interest of the Federal government or the

applicants. ACYF may also solicit comments from ACF Regional Office

staff, other Federal agencies, interested foundations, national

organizations, specialists, experts, States and the general public.

These comments, along with those of the expert reviewers, will be

considered by ACYF in making funding decisions.

To the greatest extent possible, efforts will be made to ensure

that funding decisions reflect an equitable distribution of assistance

among the States and geographical regions of the country, rural and

urban areas, and ethnic populations. In making these decisions, ACYF

may also take into account the need to avoid unnecessary duplication of

effort.

C. Evaluation Criteria

A panel of at least three reviewers (primarily experts from outside

the Federal government) will review the applications. To facilitate

this review, applicants should ensure that they address each minimum

requirement in the priority area description under the appropriate

section of the Program Narrative Statement. Applicants should be

advised that they have the option to omit, from application copies

which will be made available to non-Federal reviewers, the specific

salary rates or amounts for individuals identified in the application

budget. However, salary information must be made available in the copy

maintained in the official grants file.

[[Page 30873]]

The reviewers will determine the strengths and weaknesses of each

application using the evaluation criteria listed below, provide

comments and assign numerical scores. The point value following each

criterion heading indicates the maximum numerical weight.

All applications will be evaluated against the following criteria.

(1) Objective and Need for Assistance (20 points). The extent to

which the application pinpoints any relevant physical, economic,

social, financial, institutional or other problems requiring a

solution; demonstrates the need for the assistance; states the

principal and subordinate objectives of the project; provides

supporting documentation or other testimonies from concerned interests

other than the applicant; and includes and/or footnotes relevant data

based on the results of planning studies. The application must identify

the precise location of the project and area to be served by the

proposed project. Maps and other graphic aids may be attached.

(2) Approach (35 points). The extent to which the application

outlines a sound and workable plan of action pertaining to the scope of

the project, and details how the proposed work will be accomplished;

cites factors which might accelerate or decelerate the work, giving

acceptable reasons for taking this approach as opposed to others;

describes and supports any unusual features of the project, such as

design or technological innovations, reductions in cost or time, or

extraordinary social and community involvements; and provides for

projections of the accomplishments to be achieved. The Approach section

should include a listing of the activities to be carried out in

chronological order, showing a reasonable schedule of accomplishments

and target dates.

The extent to which, when appropriate, the application identifies

the kinds of data to be collected and maintained, and discusses the

criteria to be used to evaluate the results and successes of the

project. The extent to which the application describes the evaluation

methodology that will be used to determine if the needs identified and

discussed are being met and if the results and benefits identified are

being achieved. The application also lists each organization, agency,

consultant, or other key individuals or groups who will work on the

project, along with a description of the activities and nature of their

effort or contribution.

(3) Results or Benefits Expected (20 points). The extent to which

the application identifies the results and benefits to be derived, the

extent to which they are consistent with the objectives of the

application, and the extent to which the application indicates the

anticipated contributions to policy, practice, theory and/or research.

The extent to which the proposed project costs are reasonable in view

of the expected results.

(4) Staff Background and Organization Experience (25 points). The

application identifies the background of the project director/principal

investigator and key project staff (including name, address, training,

educational background and other qualifying experience) and the

experience of the organization to demonstrate the applicant's ability

to effectively and efficiently administer the project. The application

describes the relationships between the proposed project and other work

planned, anticipated or underway by the applicant with Federal

assistance.

D. Structure of Priority Area Descriptions

Each priority area description is composed of the following

sections:

Eligible Applicants: This section specifies the type of

organization eligible to apply under the particular priority area.

Specific restrictions are also noted, where applicable.

Purpose: This section presents the basic focus and/or broad goal(s)

of the priority area.

Background Information: This section briefly discusses the

legislative background as well as the current state-of-the-art and/or

current state-of-practice that supports the need for the particular

priority area activity. Relevant information on projects previously

funded by ACYF and/or others, and State model are noted, where

applicable.

Minimum Requirements for Project Design: This section presents the

basic set of issues that must be addressed in the application.

Typically, they relate to project design, evaluation, and community

involvement. This section also asks for specific information on the

proposed project. Inclusion and discussion of these items is important

since they will be used by the reviewers in evaluating the applications

against the evaluation criteria. Project products, continuation of the

project effort after the Federal support ceases, and dissemination/

utilization activities, if appropriate, are also addressed.

Project Duration: This section specifies the maximum allowable

length of time for the project period and refers to the amount of time

for which Federal funding is available.

Federal Share of Project Cost: This section specifies the maximum

amount of Federal support for the project for the first budget year.

Matching Requirement: This section specifies the minimum non-

Federal contribution, either through cash or in-kind match, required in

relation to the maximum Federal funds requested for the project.

Grantees must provide a share of the total approved project cost. (For

the Abandoned Infants Assistance Program, a grantee must propose at

least a 10 percent match of the total approved project cost; for the

Temporary Child Care for Children with Disabilities and Crisis

Nurseries Program, a grantee must propose at least a 25 percent match

of the total approved project cost.) The total approved project cost is

the sum of the ACF share and the non-Federal share. The non-Federal

share may be met by cash or in-kind contributions, although applicants

are encouraged to meet the match requirements through cash

contributions. Therefore, an AIA project requesting $450,000 in Federal

funds per budget period must include a match of at least $50,000 (10

percent of the total approved project cost per budget year). For a RC/

CN program requesting $200,000 in Federal funds per budget period must

include a match of at least $66,667 per budget year (25 percent of the

total approved project cost per budget year.)

Anticipated Number of Projects To Be Funded: This section specifies

the number of projects that ACYF anticipates it will fund under the

priority area.

Please note that applications that do not comply with the specific

priority area requirements in the section on ``Eligible Applicants''

will not be reviewed. Applicants should also note that non-

responsiveness to the section ``Minimum Requirements for the Project

Design'' will result in a low evaluation score by the reviewers.

Applicants must clearly identify the specific priority area under which

they wish to have their applications considered, and tailor their

applications accordingly. Previous experience has shown that an

application which is broader and more general in concept than outlined

in the priority area description scores lower than one more clearly

focused on, and directly responsive to, that specific priority area.

E. Available Funds

The ACYF intends to award new grants resulting from this

announcement during the fourth quarter of fiscal year 1996, subject to

the availability of funds. The size of the actual awards will vary.

Each priority area description includes information on the maximum

Federal share of the project costs and

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the anticipated number of projects to be funded.

The term ``budget period'' refers to the interval of time (usually

12 months) into which a multi-year period of assistance (project

period) is divided for budgetary and funding purposes. The term

``project period'' refers to the total time a project is approved for

support, including any extensions.

Where appropriate, applicants may propose project periods which are

shorter than the maximums specified in the various priority areas. Non-

Federal share contributions may exceed the minimums specified in the

various priority areas when the applicant is able to do so. However, if

the proposed match exceeds the minimum requirement, the grantee must

meet its proposed level of match support before the end of the project

period. Applicants should propose only that non-Federal share they can

realistically provide since any unmatched Federal funds will be

disallowed by ACF.

For multi-year projects, continued Federal funding beyond the first

budget period is dependent upon satisfactory performance by the

grantee, availability of funds from future appropriations and a

determination that continued funding is in the best interest of the

Government.

F. Grantee Share of Project Costs

Grantees must provide a share of the total approved cost of the

project. The total approved cost of the project is the sum of the ACF

share and the non-Federal share. The non-Federal share may be met by

cash or in-kind contributions, although applicants are encouraged to

meet their match requirements through cash contributions. For the

Abandoned Infants Assistance Program, a grantee must propose at least a

10-percent match of the total cost of the project; for the Temporary

Child Care for Children with Disabilities and Crisis Nurseries Program,

a grantee must propose at least a 25-percent match of the total cost of

the project. If approved for funding, grantee will be held accountable

for commitments of non-Federal resources and failure to provide the

required amount will result in a disallowance of unmatched Federal

funds.

G. Priority Areas Included in This Announcement:

1.01a-- Abandoned Infants Assistance Renewal Service Demonstration

Projects

1.01b--Abandoned Infants Assistance New Start Comprehensive Service

Demonstration Projects

2.01a--Temporary Child Care for Children with Disabilities and

Chronically Ill Children

2.01b--Crisis Nurseries

H. Priority Area Descriptions and Requirements

Abandoned Infants Assistance Program Service Demonstration Projects

(Priority Areas 1.01a and 1.01b)

Availability and Allocation of Funds. Total combined funding for

Priority Areas 1.01a and 1.01b for fiscal year (FY) 1996 competitive

grants under section 101 of the Act (42 U.S.C. 670 note), is

approximately $6 million.

The Administration for Children and Families proposes to award four

to eight grants in each of the two priority areas (1.01a and 1.01b) in

varying amounts up to $450,000 per budget year. Applications under this

announcement will be considered for:

Previous Service Demonstration Projects--to provide

support for the comprehensive service programs initially funded in FY

1990 and 1992 by requiring documentation of continuing need for the

project; to propose ways of improving service provision to meet the

needs of abandoned infants and young children or those who are at risk

of abandonment and their families; and to propose methods to continue

the program evaluation, including proposed outcome measures, and

summary evaluative data on the current program. Applicants applying

under this priority area should be advised this is a competitive

funding process and that applications approved for funding will be

given a new grant number. Further, existing award activities cannot

overlap with the new grant's project period; and finally, funds from

the currently existing grants cannot be expended for new grant

activities.

New Start Service Demonstration Projects--to establish a

comprehensive services program in jurisdictions not already served by

the Abandoned Infants Assistance Program to meet the needs of abandoned

infants and young children, or those who are at risk of abandonment and

their families; and to conduct a formative evaluation for Years I and

II; and to collect information on client outcomes in Years III and IV.

All applicants funded under Priority Areas 1.01a and 1.10b will be

required to provide information for special studies or evaluations

funded by the Administration on Children, Youth and Families (ACYF).

All applicants funded under this announcement will be required to

have a key person from the project staff and the evaluator attend a

grantees' meeting held annually in Washington, D.C.

The training and technical assistance services of the National

Abandoned Infants Assistance Resource Center are available to all

applicants funded under this announcement. All applicants are also

required to provide assurances that they will comply with fiscal and

program reporting requirements. These required assurances are listed

later in this program announcement.

The agency receiving the grant must assume fiscal and

administrative responsibilities for the use of grant funds. The role of

cooperating agencies must be explicit and supported by letters of

specified commitment to the project. Prescribed support letters will

not be considered responsive. Also, each application must include as a

specific goal the development of strategies to coordinate and make

optimal use of all relevant private, Federal, State and local resources

to establish and maintain services beyond the life of the grant.

Background Information. Public Law (Pub. L.) 102-236, the Abandoned

Infants Assistance Act Amendments of 1991 (the Act), amended Pub. L.

100-505, the Abandoned Infants Act of 1988 and was signed into law

December 12, 1991. The purposes of the Act are to establish a program

of demonstration projects to prevent the abandonment in hospitals of

infants and young children, particularly those who have been

perinatally exposed to a dangerous drug and those with the human

immunodeficiency virus (HIV) or who have been perinatally exposed to

the virus; to identify and address the needs of those infants and

children who are, or might be, abandoned; to develop a program of

comprehensive services for these children and members of the biological

family (see Definitions) for any condition that increases the

probability of abandonment of an infant or young child, including, but

not limited to, foster family care services, case management services,

family support services, parenting skills, in-home support services,

respite and crisis intervention services, counseling services and group

residential home services; and to recruit and train health and social

services personnel, foster care families, and residential care

providers to meet the needs of abandoned children and infants and

children who are at risk of abandonment. The legislation also allows

for the provision of technical assistance and training programs to

support the planning, development and operation of the service

demonstration projects.

[[Page 30875]]

Definitions: The legislation provides definitions for three terms,

i.e., ``abandoned infants and young children,'' ``dangerous drug,'' and

``natural family.'' The term ``abandoned infants and young children''

retains the definition stated in the original legislation (Pub. L. 100-

505) and means infants and young children who are medically cleared for

discharge from acute-care hospital settings, but who remain

hospitalized because of a lack of appropriate out-of-hospital placement

alternatives. The terms ``dangerous drug'' and ``natural family'' were

defined under Pub. L. 102-236. The term ``dangerous drug'' means a

controlled substance as defined in section 102 of the Controlled

Substances Act. Although Pub. L. 102-236 uses the term ``natural

family,'' the Administration on Children, Youth and Families prefers

the term biological family. Therefore, the term biological parents/

family/mother/father will be used for the remainder of the grant

announcement. The term biological family shall be broadly interpreted

to include biological parents, grandparents, family members, guardians,

children residing in the household and individuals residing in the

household on a continuing basis who are in a care-giving situation with

respect to infants and young children covered under this Act. (42

U.S.C. 670 note, title I, section 103.)

Statement of the Problem. Concern continues to grow about the

numbers of infants and young children infected with HIV/AIDS and/or

exposed to drugs during prenatal development. Also, there is concern

about an increase in the number of women who are using illegal drugs

during pregnancy with possible adverse consequences for their children.

In recent years, the link between female intravenous drug users,

the HIV perinatal transmission rate and the subsequent development of

the acquired immune deficiency syndrome (AIDS) in young children has

presented an enormous challenge to pediatric health care workers.

According to the most recent Centers for Disease Control (CDC) data,

there are 6,611 AIDS-infected children under 13 years of age. That

number has more than doubled since 1992 and the problem is expected to

grow.

In 1995, 977 new cases of pediatric AIDS were reported. While 70%

of AIDS cases among children have been reported from a relatively small

number of States and territories--New York, Florida, New Jersey,

Pennsylvania, Texas, California and Puerto Rico--HIV infection affects

children in nearly all parts of the country. Cases of pediatric AIDS

have been reported from 48 States. (CDC HIV/AIDS Surveillance Report,

January, 1996; AIA Factsheet, January, 1996). Women are the fastest

growing population in the AIDS epidemic. In 1992, AIDS was the fourth

leading cause of death for women of child-bearing age, 25-44 years up

from fifth in 1990 and eighth in 1987. Major studies of congenital HIV

infection indicate that perinatal transmission rates range between 14

and 40 percent. While new treatments have improved the likelihood of

children being born without the virus, an unfortunate consequence of

this is that more children born to HIV/AIDS infected women will be

orphaned. This potential increase of orphaned children will have an

impact on the child welfare services system. (CDC; AIA Factsheet,

1996).

The problem of AIDS is closely connected with perinatal substance

abuse. Fetal exposure to HIV/AIDS is linked to maternal drug use.

Mothers are most commonly infected with HIV through their own drug use

or sexual relations with an IV drug user. The National Pregnancy and

Health Survey (National Institute on Drug Abuse) reported that

approximately six percent of the four million women who gave birth in

1992 used illicit drugs, 19 percent drank alcohol and 20 percent smoked

cigarettes during pregnancy. About one-third of the illicit drug users

also smoked and/or drank alcohol during pregnancy.

The risk factors for women delivering a drug-exposed infant include

poverty, little education, poor nutrition, little or no prenatal care,

a history of sexual and/or physical abuse and being over 25, unmarried,

uninsured, on Medicaid and having other children. Similar

characteristics exist for women at risk of AIDS/HIV. They are

economically and socially disadvantaged; are primarily women of color;

lack access to adequate medical care; use drugs, alcohol and tobacco;

and are at risk for sexually transmitted diseases. Many of these women

are not even aware they are infected with HIV until they give birth and

their babies test positive. (AIA Factsheet, 1996)

The characteristics of women who abandon or who are risk of

abandoning their children are similar. These women are often struggling

with: poverty, homelessness, physically, sexually and emotionally

disruptive relationships; HIV infection; mental illness and drug

addiction. Researchers have reported that the average age of these

mothers is 27 years old; the average number of pregnancies is four; 64

percent of the mothers receive no prenatal care; and 27 percent are

incarcerated during their pregnancies. Many mothers have other children

in out-of-home care; have very little, if any, social supports;

delivered their newborns alone; and are homeless. Additionally 45

percent of the mothers have not graduated from high school; 62 percent

receive income assistance; and 80 percent use multiple drugs. (Barth et

al., 1996)

HIV infection is relatively prevalent in the abandoned infants

population. As many as eight percent of infants abandoned in hospitals

are reported to be HIV infected as compared with approximately .04

percent of all infants in the United States who are infected each year.

Due to inconsistent testing and confidentiality laws, this number may

underestimate the magnitude of the problem. (James Bell Associates,

1993)

Substance abuse has also been indicated as a significant factor in

cases of infants abandoned in hospitals. Approximately 80 percent of

these babies are prenatally exposed to illicit drugs as compared with

between five and approximately 11 percent of all babies born in the

United States. About one-third of the illicit drug users smoked tobacco

and/or drank alcohol during pregnancy. (James Bell Associates, 1993)

Children who are HIV positive or have AIDS are frequently ill and

require intensive and specialized care. The delivery of services to

these children is often complicated because the children and their

families live in communities that lack the necessary resources or

because caregivers have difficulty accessing needed services. (Barth et

al., 1996) Further complicating the situation is the fact that all of

these children have mothers who are HIV positive, and most of the

mothers are drug-abusers who themselves need medical, social and other

supportive services. Returning care to the mother may not be an option,

since the mother may be too ill herself to care for the child.

The children living with an HIV/AIDS infected parent in many ways

require as complex a range of services as the infected individual. To

date, little attention has been focused on this issue. According to the

best estimates provided by researchers thus far, the number of such

children at risk of being orphaned by the AIDS/HIV epidemic may reach

anywhere from 80,000-125,000 by the year 2000. (Levine, 1992) It is

vital that communities, in general, and child welfare services, in

particular, begin to address the issues of permanency planning for this

vulnerable population. The magnitude of the problem and the need for

appropriate planning and services to address this need have only

recently

[[Page 30876]]

been understood. Due to the episodic nature of the disease, parents and

primary caregivers will experience a direct impact on the continuity of

care that they must provide for their children. The children who will

be or are orphaned by AIDS/HIV need social services, psychological and

emotional support, medical care and the stability of a permanent home/

caregiver. (Polineni, 1995)

Although many of these services still need to be developed in

communities, some States have taken steps to address permanency for

these children. Several States have enacted Standby Guardianship Laws

to allow parents to provide for the provisional care of their child and

address the needs of both the child and the family. The laws are

designed to be flexible to meet the parents' needs and may be

implemented at any designated time including a period of illness,

hospitalization or death. Ways to provide needed services and to

eliminate the barriers to implementing permanency for this population

need to be continually explored. (Polineni, 1995)

Some children exposed to drugs, and those who acquire AIDS, pose

challenging medical and behavioral problems. Their neurological

deficits and developmental delays can prove very trying for caregivers.

Biological and foster parents, relatives, adoptive parents and other

caretakers often need special training and supportive services to help

them meet the children's needs and to provide respite for the

caretakers themselves.

Achieving permanency for such children is typically slow and

complex. Some parents may be motivated to keep the child, but not to

change their behaviors; other parents may be motivated to change their

behaviors, but are incapable of accessing the appropriate services on

their own or of maintaining improved behaviors in their current

environment. The assistance required to address the service needs of

the parent may be fragmented among many different agencies. Some

services may not be readily available. Some, such as drug treatment,

may not be readily available for pregnant women. Some services may not

be culturally sensitive, and others may not be entirely appropriate to

the client's needs.

If permanency is to be achieved early in the life of the developing

child, intensive efforts must be made with the family to determine its

suitability to care for the child. If that is not possible, steps must

be taken toward constructive long-term solutions to provide permanency

for the child. Toward these ends, systematic action must be taken to

obtain and deliver a comprehensive set of services to the biological

and/or foster or adoptive family and the child.

A number of discretionary programs within ACYF and throughout the

Department of Health and Human Services fund projects which are related

to the issues addressed by this announcement. A brief description of

these programs with the name of a contact person is attached in

Appendix IV. Prospective applicants for Priority Areas 1.01a and 1.01b

must, if applicable, include these existing programs in the service

network proposed and provide a description of the proposed networking

activities.

Emphasis on Coordination. All New Start Service Demonstration

Project applicants should utilize an existing consortium or develop a

consortium or other coordinating entity for the purpose of carrying out

the project funded under this announcement. The consortium may include

public health, child welfare, substance abuse treatment and other

relevant human services agencies. To the extent possible, applicants

are encouraged to formalize working relationships with the police and

courts; mental health, developmental disabilities, Head Start, and

special education providers, community-based maternal and child health

programs; and community parent education and parent support programs,

including in-home visiting, respite care and housing assistance in the

community. Plans for coordinating joint medical-social service case

management, outstationing child welfare staff at hospitals where large

numbers of at-risk infants are being delivered, or other methods to be

used to bring about comprehensive service delivery should be described

in the application and supported by documentation.

All currently funded grantees seeking new grant funding should

continue to use their existing consortia. These grantees shall: (1)

describe ways in which the consortium can be expanded, if possible, or

changed, if necessary; and (2) demonstrate how the consortium has

improved communication and working relationships between and among

community agencies in coordinating services for this target population.

1.01a. Previous Service Demonstration Projects

Eligible Applicants: The 15 comprehensive service demonstration

grantees initially funded in fiscal year 1990 and the four service

demonstrations funded initially in FY 1992.

Fifteen service demonstration projects initially funded in FY 1990

under Section 101, Pub. L. 100-505 and four service demonstrations

projects initially funded in FY 1992 under Pub. L. 102-236 are eligible

for new grants under this priority area. Applicants must show progress

and accomplishments to date on the original goals and objectives of

their current grant.

Minimum Requirements for Project Design: Applications submitted

under this priority area are to include approaches/strategies to

organize, make accessible and implement a comprehensive set of services

to:

Prevent the abandonment of infants and young children,

including the provision of services to members of the biological family

to address any condition that increases the probability of abandonment

of an infant or young child;

Prevent the subsequent abandonment of infants and young

children when they return to their homes;

Assist abandoned infants and young children to reside with

their biological families, relatives or foster and adoptive families,

as appropriate, and to include the provision of respite care as needed.

Short-term, transitional residential care services for small groups of

infants or young children may be provided. For these services, however,

it must be shown that the placements are necessary because a sufficient

number of families cannot be recruited and trained to provide foster

family care for abandoned infants and young children in the community

or that such placements are in the best interests of the child.

Proposals including residential care services will be considered only

if that component is part of and integral to a larger system of

services directed toward achieving permanency for the children; and

only if the residential services are designed to be transitional (i.e.,

three to six months) to a permanent placement. The proposal may not

include the costs of construction or other major structural changes for

facilities.

Previous grantees must include an outcome analysis of prior

evaluation(s).

Applicants are encouraged to revise or to expand their goals and

objectives based on a review of the development and implementation of

the program. The review should include an assessment of the

effectiveness of the approaches and intervention strategies initially

proposed. If revised approaches were used, they should also be assessed

for their effectiveness. This process should also include an assessment

of problems in program implementation and a

[[Page 30877]]

discussion of the proposed improved strategies to address those

barriers.

In developing a broad and comprehensive approach, potential

grantees should consider the wide range of assistance needed by the

target population including parenting skills; supportive, therapeutic

services; housing and transportation; health care and drug and alcohol

treatment. Infants exposed to drugs and AIDS/HIV often need specialized

health care and therapeutic intervention to assist them in their

physical and cognitive development.

Section 101 (a)(8) of Pub. L. 102-236 requires projects to

demonstrate methods through model programs of providing health,

education and social services at a single site in a geographic area in

which a significant number of infants and young children affected by

drugs and HIV/AIDS reside. To the extent possible, applicants should

develop a program of service delivery that provides these services at a

single site. If not, provide an explanation how these services will be

readily accessible to the client families.

Based on several years of experience in implementing services

programs targeted for families at risk of abandonment, there are

several strategies/approaches that can be considered successful in

working with the target population. Potential applicants are encouraged

to consider these strategies in the proposed program implementation.

They include:

Interagency Collaboration--Services to the target

population need to be comprehensive and seamless and require more

resources than any single agency can provide. Interagency collaboration

coordinates service development and funding between multiple agencies

serving the same population.

Intervention Teams--These teams bring together

professionals from a variety of disciplines in the planning and

delivery of services. An interdisciplinary team provides a variety of

service perspectives and a more holistic assessment of needs and a more

complete treatment plan.

Peer Services--Peer staff have backgrounds and experiences

similar to the clients and serve as a bridge between the client and

professional worlds. Peer staff are more accessible and less

threatening to the clients and can establish more trusting and more

supportive relationships.

Home-based Services--Educational, supportive and

therapeutic services are provided in the client's home and can improve

client assessment and service provision by giving a fuller

understanding of the client's circumstances. Further, lack of

transportation and child care create serious barriers to agency-based

services.

Culturally Appropriate and Women-focused Services--This

emphasis enables the services to be provided in an environment that

acknowledges, reflects and respects the cultural and ethnic influences

of the client population and recognizes the needs that particularly

affect women.

Coordinated Medical and Social Service Case Management--

These case management services aid in the timely discharge of infants

and reduce medically unnecessary hospital days and expedite hospital

discharges to the most family-like settings.

Legal, Policy and Program Development--These services

provide permanency for HIV-affected children and to help keep children

orphaned by AIDS from entering the child welfare system.

Other strategies/approaches potential applicants are encouraged to

consider are options regarding family mediation and voluntary

relinquishment. These techniques are useful in establishing permanency

for children after it has been decided that targeted infants and

children cannot return home.

Family Mediation--This is a voluntary, non-coercive

negotiation process facilitated by a neutral, third-party. The goal of

mediation is to encourage birth parent(s), extended relatives and

foster/adoptive parents to cooperate in making decision that reflect

the best interests of the child. Mediation empowers the biological

parent(s) and recognizes the need of the child to maintain family ties.

Relinquishment--This is a voluntary process of

transferring parental rights to an authorized child welfare agency and

is usually a front-end approach that occurs prior to court involvement.

The application must include an assurance of a third party

evaluation of the project. In order to evaluate the competence of the

third-party evaluator and to assure that the evaluation methodology and

design are appropriate, the third party evaluator must write the

evaluation section of the application. This means that the evaluator

must be selected as soon as possible after an applicant has decided to

compete for a demonstration project. In selecting an evaluator,

applicants are reminded that it is a regulatory requirement to

encourage maximum free and open competition, using the applicant's own

procurement policies and procedures. The application must indicate

whether the third party evaluator was competitively selected, or

whether the applicant is proposing a sole source contract for the

evaluator. Sole source procurements must be fully justified in the

application. For those applicants who plan to continue the services of

their current third party evaluator, the applicant must include in the

application a sole source justification for review, by the program

office and the Division of Discretionary Grants, ACF.

The evaluation component of the application should include methods

of collecting descriptive data on the characteristics of the clients

served and the services provided; and measures of client outcomes. In

developing the evaluation component, applicants are required to collect

outcome data on the following:

Substance abuse treatment and recovery;

Target infant/child characteristics, including gestational

age, birth weight, HIV status at birth/15 months, drug screen results;

Target infant/child placement status--at program intake,

12 months after enrollment in the program and at termination;

Client termination--child placement status at 12 months

after leaving the program.

Additionally, the applicants are required to collect data on the

following outcomes. Applicants are strongly encouraged, although not

required to use the suggested data collection instruments indicated:

Child development and well-being at program intake and 12

months after enrollment. Data should also be collected on child

injuries, hospitalizations or death following case openings. Suggested

instruments include: Bayley Scale of Infant Development; Brazelton

Neonatal Behavioral Assessment Scale; Denver Developmental Screening

Test; Infant Behavior Questionnaire; and Child Well-Being Scales.

Client satisfaction at three, six, twelve months and

termination. Suggested instruments include: Client Feedback and

Customer Satisfaction Survey.

In addition to the required data elements, applicants are

encouraged, but not required to collect data on the following elements.

Suggested data collection instruments are also included:

Parenting skills--Suggested instruments: Parental Outcomes

Interview; Knowledge of Chid Development Questionnaire;

[[Page 30878]]

Parent (caregiver) child interaction--Suggested

instruments: Parental Outcomes Involvement Scale; Parent-Child Early

Relational Assessment; and

Cost Benefit--Discussion of a how the project reduces the

financial burden on community services, e.g., reduction in the number

of days of hospitalization.

Successful applicants will be asked to submit descriptive data on

the clients served and the services provided annually to the National

AIA Resource Center. Timeframes for the submission of data on outcome

measures will be negotiated within six months after grant award.

Applicants are required to have, at a minimum, a key staff person

from the project and the evaluator will attend the annual 2-3 day

grantees' meeting in Washington, D.C. The applicant is further required

to participate in any evaluation effort supported by ACYF.

Project Duration: The length of the renewal project period for the

competing service demonstration grantees may not exceed 48 months.

Federal Share of Project Costs: Grant amounts will vary and range

up to $450,000 for each of four years. The dollar amount requested must

be fully justified and documented. The justification can include

various community-specific factors related to substance abuse and

perinatal exposure to drugs or HIV. For example, the applicant might

include information on the rate of illegal drug use by women of child-

bearing age; the rate of HIV positive women giving birth; the number of

known drug users; the rate or number of infants who have a positive

toxicology screen. The size of a prior grant award is not, in and of

itself, adequate justification to request the same amount under this

announcement.

Renewal applicants must commit no less that 10% of the total

approved project cost for the evaluation component. For example, a

$450,000 grant award with a $50,000 match should commit no less than

$50,000 annually to the evaluation effort or a total of no less than

$200,000 during the entire project period.

Matching Requirement: Grantees must provide at least 10 percent of

the total approved cost of the project. The total approved cost of the

project is the sum of the ACF share and the non-Federal share. The non-

Federal share may be met by cash or in-kind contributions, although

applicants are encouraged to meet their match requirements through cash

contributions. Therefore, a project requesting a total of $1,800,000 in

Federal funds for all four project years (based on an award of $450,000

per budget year), must include a match of at least $200,000 (10 percent

of total approved project costs, i.e., $50,000 per budget period).

Anticipated Number of Projects to be Funded: It is anticipated that

four to eight projects will be funded.

Length of Proposal: The length of the proposal is limited to 75

pages, including all preprinted pages, and budget narrative, but

exclusive of appendices.

1.01b. New Start Comprehensive Service Demonstration Projects

Eligible Applicants: Any State, local public or nonprofit agency or

organization including accredited colleges and universities. Applicants

in jurisdictions in which there currently does not exist a program

funded under the Abandoned Infants Assistance Program will be

considered under this priority area. Applicants from localities in

which projects are currently operating (see Appendix A) will not be

considered as the purpose of this priority area is to establish

comprehensive service projects in new localities. Exceptions to this

may be considered for large metropolitan areas, that is, cities with a

population over 1,000,000.

Minimum Requirements for Project Design: Under this priority area

applications will be considered which are designed to organize, make

accessible, and implement a comprehensive set of services to:

Prevent the abandonment in hospitals of infants and young

children, including the provision of services to members of the

biological family for any condition that increases the probability of

abandonment of an infant or young child;

Prevent the subsequent abandonment of infants and young

children after they have returned home with their parent(s);

Assist abandoned infants and children to reside with their

biological families, relatives or foster and adoptive families, as

appropriate, including the use of respite care programs. Short-term,

transitional residential care services for small groups of infants or

young children may be provided. For these services, however, it must be

shown that a sufficient number of families cannot be recruited and

trained to provide foster care for abandoned infants or young children

in the community, or that such placements are in the best interests of

the child. Proposals which include residential care services will be

considered only if that component is part of and integral to a larger

system of services directed toward achieving permanency for the

children; and only if the residential services are designed to be

transitional (i.e., three to six months) to a permanent placement.

These applications may not include the costs of construction or other

major structural changes for facilities.

In order to assure that consideration is given to the widest range

of possible interests for program development, applicants must consider

the broad range of possible circumstances confronting at-risk parents

in the target community, including the following:

Before pregnancy: educational services on family planning,

pre-conception counseling and prenatal care, emphasizing the dangers of

substance abuse, and other issues related to the prevention of

abandonment;

During pregnancy: sensitizing all programs in the

community to the importance of recognizing drug abuse during pregnancy

and providing voluntary services as often as possible;

Pregnant women in trouble where drug use is a factor:

women who are arrested, victims of domestic violence, or reported to

protective services for child maltreatment need special attention;

Women from high drug use areas seeking prenatal care, or

entering a hospital for delivery;

Parents of infants who must remain in the hospital for any

medical reasons related to HIV or possible drug involvement; or

Families with drug exposed infants and young children in

need of support programs.

Applicants for a comprehensive service project under this priority

may include training activities as a part of the project.

In developing a broad and comprehensive approach, potential

grantees should consider the wide range of assistance needed by the

target population including, parenting and supportive, therapeutic

services; housing and transportation; health care and drug and alcohol

treatment. Infants exposed to drugs and AIDS/HIV often need specialized

health care and therapeutic intervention to assist them in their

physical and cognitive development.

Section 101 (a)(8) of Pub. L. 102-236 requires projects to

demonstrate methods through model programs of providing health,

education and social services at a single site in a geographic area in

which a significant number of infants and young children affected by

drugs or HIV/AIDS reside. To the extent possible, applicants should

consider the possibility of providing these services at

[[Page 30879]]

a single site. If not, provide an explanation how these services will

be accessible to the clients.

Based on several years of experience in implementing services

programs targeted for families at risk of abandonment, there are

several strategies/approaches that can be considered successful in

working with the target population. Potential applicants are encouraged

to consider these strategies in the proposed program implementation.

They include:

Interagency Collaboration--Services to the target

population need to be comprehensive and seamless and require more

resources than any single agency can provide. Interagency collaboration

coordinates service development and funding between multiple agencies

serving the some population.

Intervention Teams--These teams bring together

professionals from a variety of disciplines in the planning and

delivery of services. An interdisciplinary team provides a variety of

service perspectives and a more holistic assessment of needs and a more

complete treatment plan.

Peer Services--Peer staff have backgrounds and experiences

similar to the clients and serve as a bridge between the client and

professional worlds. Peer staff are more accessible and less

threatening to the clients and can establish more trusting and more

supportive relationships.

Home-based Services--Educational, supportive and

therapeutic services are provided in the client's home and can improve

client assessment and service provision by giving a fuller

understanding of the client's circumstances. Further, lack of

transportation and child care create serious barriers to agency-based

services.

Culturally Appropriate and Women-focused Services--This

emphasis enables the services to be provided in an environment that

acknowledges, reflects and respects the cultural and ethnic influences

of the client population and recognizes the needs that particularly

affect women.

Coordinated Medical and Social Service Case Management--

These case management services aid in the timely discharge of infants

and reduce medically unnecessary hospital days and expedite hospital

discharges to the most family-like settings.

Legal, Policy and Program Development--These services

provide permanency for HIV-affected children and to help keep children

orphaned by AIDS from entering the child welfare system.

Other strategies/approaches potential applicants are encouraged to

consider are options regarding family mediation and voluntary

relinquishment. These techniques are useful in establishing permanency

for children after it has been decided that targeted infants and

children cannot return home.

Family Mediation--This is a voluntary, non-coercive

negotiation process facilitated by a neutral, third-party. The goal of

mediation is to encourage birth parent(s), extended relatives and

foster/adoptive parents to cooperate in making decisions that reflect

the best interests of the child. Mediation empowers the biological

parent(s) and recognizes the need of a the child to maintain family

ties.

Relinquishment--This is a voluntary process of

transferring parental rights to an authorized child welfare agency and

is usually a front-end approach that occurs prior to court involvement.

Each service demonstration project must propose to carry out a

third-party evaluation as an integral part of the demonstration effort.

In order to evaluate the competence of the third-party evaluator and to

assure that the evaluation methodology and design are appropriate, the

third party evaluator must write the evaluation section of the

application. This means that the evaluator must be selected as soon as

possible after an applicant has decided to compete for a demonstration

project. In selecting an evaluator, applicants are reminded that ACF

encourages maximum free and open competition, using the applicant's own

procurement policies and procedures. The application must indicate

whether the third party evaluator was competitively selected, or

whether the applicant is proposing a sole source contract for the

evaluator. Sole source requests must be fully justified in the

application.

Applicants under this priority area should consider a tiered

evaluation plan: (1) to collect formative evaluation data and (2) to

collect data on outcome measures as the information becomes available.

The application should address both aspects even though process data

may be the only reportable data available during Years I and II of the

project. The evaluation component of the application should include

methods of collecting descriptive data on the characteristics of the

clients served and the services provided. This evaluation should be

designed to collect systematic data to answer questions such as the

following: What are the characteristics of families who abandon

children? What are the service needs of children/mothers/fathers/

families of drug exposed infants? Of HIV positive infants? What are the

barriers to comprehensive case management and to the coordination of

service delivery? What changes have been most helpful in improving the

delivery of services? What changes/improvements have there been in the

child's well-being and/or child's development? What changes have there

been in the family's stability and ability to function? What are the

permanency outcomes for children?

In developing the outcome measures component of the evaluation,

applicants be required to collect outcome data on the following:

Substance abuse treatment and recovery;

Target infant/child characteristics, including gestational

age, birth weight, HIV status at birth/15 months, drug screen results;

Target infant/child placement status--at program intake,

12 months after enrollment in the program and at termination;

Client termination--child placement status at 12 months

after leaving the program.

Additionally, the applicants will be required to collect data on

the following outcomes. Applicants are strongly encouraged, although

not required to use the suggested data collection instruments

indicated:

Child development and well-being at program intake and 12

months after enrollment. Data should also be collected on child

injuries, hospitalizations or death following case openings. Suggested

instruments include: Bayley Scale of Infant Development; Brazelton

Neonatal Behavioral Assessment Scale; Denver Developmental Screening

Test; Infant Behavior Questionnaire; and Child Well-Being Scales.

Client satisfaction at three, six, twelve months and

termination. Suggested instruments include: Client Feedback and

Customer Satisfaction Survey.

In addition to the required data elements, applicants are

encouraged, but not required to collect data on the following elements.

Suggested data collection instruments are also included:

Parenting skills--Suggested instruments: Parental Outcomes

Interview; Knowledge of Child Development Questionnaire;

Parent (caregiver) child interaction--Suggested

instruments: Parental Outcomes Involvement Scale; Parent-Child Early

Relational Assessment; and

Cost Benefit--Discussion of how the project reduces the

financial burden

[[Page 30880]]

on community services, e.g., reduction in the number of days of

hospitalization.

Successful applicants will be required to submit descriptive data

on the clients served and the services provided annually to the

National AIA Resource Center. Timeframes for the submission of data on

outcome measures will be negotiated within six months after grant

award.

Applicants are required to have, at a minimum, a key staff person

from the project and the evaluator will attend the annual 2-3 day

grantees' meeting in Washington, D.C. The applicant is further required

to participate in any evaluation effort supported by ACYF.

Project Duration: The project period may not exceed 48 months.

Federal Share of Project Costs: The maximum Federal share is

$450,000 per budget year. However, applicants are strongly encouraged

to construct the budget request judiciously. Factors to be considered

include the population of the area to be served; the extent of maternal

substance abuse in the target area; the number of drug-exposed infants;

the number of women with AIDS or women who are HIV positive in the

target area; the number of reports/referrals to social service agencies

of babies born with illegal substances in their system. For example, a

city which currently receives a $450,000 grant per budget year under

this legislation has the following profile: a population of 2-3

million; 20 percent of newborns have been pre-natally exposed to drugs;

2,000 reported allegations of child maltreatment involving infants in

substance-abusing families are received annually; approximately 350-375

women with AIDS living in the jurisdiction; an estimated 2,500-3,000

HIV positive women and between 700-800 HIV positive children; and an

annual projected number of 500 children born who are HIV-positive. Each

applicant should compare statistics from its area to the example city

and develop its budget request accordingly. This profile does not

necessarily exclude an application from a jurisdiction of smaller size

receiving the maximum Federal amount. However, an applicant from a

smaller-sized jurisdiction must provide adequate justification that the

community's experience with drug exposed and/or HIV-positive infants is

severe enough to warrant the maximum Federal amount.

Applicants under this priority area must commit no less than five

percent of the total project cost for the evaluation component. For

example, a $450,000 grant award with a $50,000 match should commit no

less than $25,000 annually to the evaluation effort or no less than a

total of $100,000 during the project period. Applicants are encouraged

to increase the financial commitment to evaluation in Year III and IV.