Special Project Grants and Cooperative Agreements; Maternal and Child Health Services; Federal Set-Aside Program; Comprehensive Hemophilia Centers, Genetic Services, and Maternal and Child Health Improvement Projects

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration

Special Project Grants and Cooperative Agreements; Maternal and

Child Health Services; Federal Set-Aside Program; Comprehensive

Hemophilia Centers, Genetic Services, and Maternal and Child Health

Improvement Projects

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

ACTION: Notice of availability of funds.

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SUMMARY: The HRSA announces that applications will be accepted for

fiscal year (FY) 1996 funds for grants and cooperative agreements for

the following activities: Maternal and Child Health (MCH) Special

Projects of Regional and National Significance (SPRANS), including

comprehensive hemophilia diagnostic and treatment centers; genetic

disease testing, counseling and information services; and special MCH

improvement projects (MCHIP) which contribute to the health of mothers,

children, and children with special health care needs (CSHCN). All

awards will be made under the program authority of section 502(a) of

the Social Security Act, the MCH Federal Set-Aside Program. A revised

regulation implementing the Federal Set-Aside Program (42 CFR part 51a)

was published in the July 19, 1994, issue of the Federal Register at 59

FR 36703. Within the HRSA, SPRANS grants are administered by the

Maternal and Child Health Bureau (MCHB). Awards are made for grant

periods which generally run from 1 up to 5 years in duration. Grants

for SPRANS research and training are being announced in a separate

notice.

This program announcement is subject to the appropriation of funds.

Applicants are advised that this program announcement is a contingency

action being taken to assure that should funds become available for

this purpose, they can be awarded in a timely fashion consistent with

the needs of the program as well as to provide for even distribution of

funds throughout the fiscal year. At this time, given a continuing

resolution and the absence of FY 1996 appropriations for the MCH

Federal Set-Aside Program, the amount

[[Page 12077]]

of available funding for this specific grant program cannot be

estimated.

The Public Health Service (PHS) is committed to achieving the

health promotion and disease prevention objectives of Healthy People

2000, a PHS-led national activity for setting priority areas. The MCH

Block Grant Federal Set-Aside Program addresses issues related to the

Healthy People 2000 objectives of improving maternal, infant, child and

adolescent health and developing service systems for children with

special health care needs. Potential applicants may obtain a copy of

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

People 2000 (Summary Report: Stock No. 017-001-00473-1) through the

Superintendent of Documents, Government Printing Office Washington, DC

20402-9325 (telephone: 202 783-3238).

The PHS strongly encourages all grant recipients to provide a

smoke-free workplace and promote the non-use of all tobacco products.

In addition, Public Law 103-227, the Pro-Children Act of 1994,

prohibits smoking in certain facilities (or in some cases, any portion

of a facility) in which regular or routine education, library, day

care, health care or early childhood development services are provided

to children.

ADDRESSES: Grant applications for MCH SPRANS hemophilia, genetics, and

MCHIP grants must be obtained from and submitted to: Chief, Grants

Management Branch, Office of Operations and Management, Maternal and

Child Health Bureau, Health Resources and Services Administration, Room

18-12, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857,

(301) 443-1440. Applicants will use revised PHS form #5161-1, approved

by the Office of Management and Budget (OMB) under control number 0937-

0189. You must obtain application materials in the mail. Written

requests should specify the category or categories of activities for

which an application is requested so that the appropriate materials may

be provided.

Federal Register notices and application guidance for MCHB programs

are available on the World Wide Web via the Internet at address: http:/

/www.os.dhhs.gov/hrsa/mchb. Click on the file name you want to download

to your computer. It will be saved as a self-extracting (Macintosh or)

Wordperfect 5.1 file. To decompress the file once it is downloaded,

type in the file name followed by a . The file will expand to a

Wordperfect 5.1 file. If you have difficulty accessing the MCHB Home

Page via the Internet and need technical assistance, please contact

Linda L. Schneider at 301-443-0767 or ``[email protected]''.

DATES: Potential applicants are invited to request application packages

for the specific program category in which they are interested, and to

submit their applications for funding consideration. Deadlines for

receipt of applications differ for the several categories of grants.

These deadlines may be found in Section 5, below, for each category

covered by this notice.

Applications will be considered to have met the deadline if they

are either: (1) Received on or before the deadline date, or (2)

postmarked on or before the deadline date and received in time for

orderly processing. Applicants should request a legibly dated receipt

from a commercial carrier or the U.S. Postal Service, or obtain a

legibly dated U.S. Postal Service postmark. Private metered postmarks

will not be accepted as proof of timely mailing. Late applications or

those sent to an address other than specified in the ADDRESS section

will be returned to the applicant.

FOR FURTHER INFORMATION CONTACT: Requests for technical or programmatic

information should be directed to the contact persons identified below

for each category covered by this notice. Requests for information

concerning business management issues should be directed to: Acting

Grants Management Officer (GMO), MCHB, at the address specified in the

ADDRESS section.

SUPPLEMENTARY INFORMATION: To facilitate the use of this announcement,

information in this section has been organized, as outlined in the

Table of Contents below, into a discussion of: Program Background,

Special Concerns, Evaluation Protocol, Project Review and Funding,

SPRANS Project Grants, Public Comment, Eligible Applicants, and Public

Health System Reporting Requirements. In addition, for each research

and training funding category or subcategory, information is presented

under the following headings:

Application Deadline.

Purpose.

Priorities.

Special Eligibility Considerations.

Project Period.

Contact.

Table of Contents

1. Program Background and Objectives

2. Special Concerns

3. Evaluation Protocol

4. Project Review and Funding

4.1. Criteria for Review

4.2. Funding of Approved Applications

5. Special Projects of Regional and National Significance

5.1. Grants

5.1.1. Comprehensive Hemophilia Diagnostic and Treatment

5.1.2. Genetic Disease Testing, Counseling and Information

5.1.3. Maternal and Child Health Improvement Projects

5.1.3.1. State Systems Development Initiative

5.1.3.2. Transition Services in Adolescent Health

5.1.3.3. Universal Newborn Hearing Screening

5.1.3.4. Data Utilization and Enhancement

5.1.3.5. Healthy Tomorrows Partnerships for Children

5.2. Cooperative Agreements

5.2.1. Maternal and Child Health Providers Partnership

5.2.2. Partnership for Information and Communication

5.2.3. Fetal/Infant Mortality Review Program Support Center

5.2.4. Partnership for Adolescent Health

6. Public Comment

7. Eligible Applicants

8. Public Health System Reporting Requirements

9. Executive Order 12372

1. Program Background and Objectives

Under Section 502 of the Social Security Act, as amended by the

Omnibus Budget Reconciliation Act (OBRA) of 1989, 12.75 percent of

amounts appropriated for the MCH Block Grant in excess of $600 million

are set aside by the Secretary of Health and Human Services (HHS) for

special Community Integrated Service Systems projects under Section

501(a)(3) of the Act. Of the remainder of the total appropriation, 15

percent of the funds are to be retained by the Secretary to support

(through grants, contracts, or otherwise) special projects of regional

and national significance, research, and training with respect to

maternal and child health and children with special health care needs

(including early intervention training and services development); for

genetic disease testing, counseling, and information development and

dissemination programs; for grants (including funding for comprehensive

hemophilia diagnostic treatment centers) relating to hemophilia without

regard to age; and for the screening of newborns for sickle cell

anemia, and other genetic disorders and follow-up services. The MCH

SPRANS set-aside was established in 1981. Support for projects covered

by this announcement will come from the SPRANS set-aside. Applications

for FY 1996 funds for MCH research and training grants are being

solicited separately from other SPRANS grants this year in order to

reduce confusion to potential applicants from

[[Page 12078]]

announcement of grants in very large numbers of SPRANS categories and

subcategories.

2. Special Concerns

In its administration of the MCH Services Block Grant, the MCHB

places special emphasis on improving service delivery to women and

children from racial and ethnic minority populations who have had

limited access to accessible care. This means that SPRANS projects are

expected to serve and appropriately involve in project activities

individuals from the populations to be served, unless there are

compelling programmatic or other justifications for not doing so. The

MCHB's intent is to ensure that project interventions are responsive to

the cultural and linguistic needs of special populations, that services

are accessible to consumers, and that the broadest possible

representation of culturally distinct and historically underrepresented

groups is supported through programs and projects sponsored by the

MCHB. This same special emphasis applies to improving service delivery

to children with special health care needs.

In keeping with the goals of advancing the development of human

potential, strengthening the Nation's capacity to provide high quality

education by broadening participation in MCHB programs of institutions

that may have perspectives uniquely reflecting the Nation's cultural

and linguistic diversity, and increasing opportunities for all

Americans to participate in and benefit from Federal public health

programs, HRSA will place a funding priority on projects from

Historically Black Colleges and Universities (HBCU) or Hispanic Serving

Institutions (HSI) in all categories and subcategories in this notice

for which applications from academic institutions are encouraged. This

is in conformity with the Federal Government's policies in support of

White House Initiatives on Historically Black Colleges and Universities

(Executive Order 12876) and Educational Excellence for Hispanic

Americans (Executive Order 12900). An approved proposal from a HBCU or

HSI will receive a 0.5 point favorable adjustment of the priority score

in a 4 point range before funding decisions are made.

3. Evaluation Protocol

With the exception of SPRANS hemophilia projects--which have an

alternative assessment mechanism in place--an MCH discretionary grant

project, including a SPRANS, is expected to incorporate a carefully

designed and well planned evaluation protocol capable of demonstrating

and documenting measurable progress toward achieving the project's

stated goals. The protocol should be based on a clear rationale

relating the grant activities, the project goals, and the evaluation

measures. Wherever possible, the measurements of progress toward goals

should focus on health outcome indicators, rather than on intermediate

measures such as process or outputs. A project lacking a complete and

well-conceived evaluation protocol as part of the planned activities

will not be funded.

4. Project Review and Funding

Within the limit of funds determined by the Secretary to be

available for the activities described in this announcement, the

Secretary will review applications for funds under the specific project

categories in section 4, below, as competing applications and may award

Federal funding for projects which will, in her judgment, best promote

the purpose of title V of the Social Security Act, with special

emphasis on improving service delivery to women and children from

culturally distinct populations; best address achievement of Healthy

Children 2000 objectives related to maternal, infant, child and

adolescent health and service systems for children at risk of chronic

and disabling conditions; and otherwise best promote improvements in

maternal and child health.

4.1 Criteria for Review

The criteria which follow are used, as pertinent, to review and

evaluate applications for awards under all SPRANS grants and

cooperative agreement project categories announced in this notice.

Further guidance in this regard is supplied in application guidance

materials, which may specify other criteria.

--The quality of the project plan or methodology.

--The need for the research or training.

--The extent to which the project will contribute to the advancement of

maternal and child health and/or improvement of the health of children

with special health care needs.

--The extent to which the project is responsive to policy concerns

applicable to MCH grants and to program objectives, requirements,

priorities and/or review criteria for specific project categories, as

published in program announcements or guidance materials.

--The extent to which the estimated cost to the Government of the

project is reasonable, considering the anticipated results.

--The extent to which the project personnel are well qualified by

training and/or experience for their roles in the project and the

applicant organization has adequate facilities and personnel.

--The extent to which, insofar as practicable, the proposed activities,

if well executed, are capable of attaining project objectives.

--The strength of the project's plans for evaluation.

--The extent to which the project will be integrated with the

administration of the MCH Block Grant, State primary care plans, public

health, and prevention programs, and other related programs in the

respective State(s).

--The extent to which the application is responsive to the special

concerns and program priorities specified in this notice.

4.2 Funding of Approved Applications

Final funding decisions for SPRANS grants are the responsibility of

the Director, MCHB. In considering scores for the ranking of approved

applications for funding, preferences may be exercised for groups of

applications; for example, new projects may be funded ahead of

competing continuations, or vice versa. Within any category of approved

projects, the score of an individual project may be favorably adjusted,

as noted in the notice or in guidance for that category, if the project

addresses specific identified priorities. In addition, special

consideration in assigning scores may be given by reviewers to

individual applications that address areas identified in this notice as

special concerns.

5. Special Projects of Regional and National Significance

Three categories of SPRANS grants are discussed below:

Comprehensive Hemophilia Diagnostic and Treatment Centers; Genetic

Disease Testing, Counseling and Information; and Maternal and Child

Health Improvement Projects.

5.1 Grants

Three major categories of SPRANS grants are discussed below:

Comprehensive Hemophilia Diagnostic and Treatment Centers; Genetic

Disease Testing, Counseling and Information; and Maternal and Child

Health Improvement Projects (in 5 sub-categories):

[[Page 12079]]

5.1.1. Comprehensive Hemophilia Diagnostic and Treatment Centers

Application Deadline: June 17, 1996.

Purpose: To provide comprehensive hemophilia diagnostic

and treatment services to individuals with hemophilia and other

congenital bleeding disorders through a regional network of

approximately 140 comprehensive hemophilia diagnostic and treatment

centers and for regional coordination.

Priorities: The following overall program goals are

priorities; to be eligible for consideration, proposals must address

all of these:

--Access to comprehensive care for hemophilia and HIV as described in

``Standards and Criteria for the Care of Persons with Congenital

Bleeding Disorders'' as published by the National Hemophilia Foundation

(NHF).

--Fostering development of comprehensive care systems that provide

culturally sensitive, family-centered care, coordinated through a

regional system of hemophilia diagnostic and treatment centers.

--Outreach and increased access to comprehensive care, especially to

the underserved and minorities.

--Emphasis on prevention to reduce complications and morbidity

associated with hemophilia.

--Provision of services to women with congenital bleeding disorders.

--Collaboration and coordination of services with State Title V

Maternal and Child Health programs; Ryan White Titles I, II, and III;

community based organizations; State and local health agencies; Ryan

White Title IV Pediatric HIV projects funded by the MCHB; and education

and peer support activities of the NHF, such as Men's Advocacy Network

of NHF (MANN), Women's Outreach Network of NHF (WONN) and Chapter

Outreach Development Program (CODP); and with the Centers for Disease

Control and Prevention (CDC) regarding the provision of HIV prevention,

risk reduction, and counseling services, especially those targeted to

adolescents and their sexual partners.

--Evidence of formal patient choice and grievance policies and

procedures.

Preference for funding will be given to existing MCHB-supported

comprehensive hemophilia diagnostic and treatment centers that have

demonstrated high performance in development and coordination of

regional services.

Project Period: The project period is 3 years.

Contact: For programmatic or technical information,

contact Patrick McGuckin, on (301) 443-9051.

5.1.2. Genetic Disease Testing, Counseling and Information

Application deadline: April 29, 1996.

Purpose: To support projects that demonstrate increased

access to effective genetic information, education, testing, and

counseling services.

Priorities: Applicants are invited to submit proposals to

broaden access to genetic services through the following:

--A council of regional networks for genetic services. To coordinate

activities and facilitate collaboration of ten regional genetic

services networks supported by MCHB, and to address issues of genetic

services in public health programs at the national level.

--Four regional genetic services networks. To develop and maintain

infrastructures for genetic services in the Midwest/Great Plains, Mid-

Atlantic, New England, and Southeast regions of the United States.

--An alliance of genetic support groups. To maintain a national

coalition of genetics support groups, consumers, and professionals to

improve responsiveness of genetic services to concerns of individuals

and families affected by genetic disorders.

Preference for funding will be given to existing MCHB-supported

comprehensive genetic projects that have demonstrated high performance

in fulfilling the above priorities.

Project Period: Project periods are up to 3 years.

Contact: For programmatic or technical information,

contact Jane S. Lin-Fu, M.D., telephone 301/443-1080.

5.1.3. Maternal and Child Health Improvement Projects

Maternal and Child Health Improvement Projects (MCHIP) are divided

into five subcategories: State Systems Development Initiative;

Transition Services in Adolescent Health; Universal Newborn Hearing

Screening; Data Utilization and Enhancement; and Healthy Tomorrows

Partnerships for Children

5.1.3.1. State Systems Development Initiative.

Application Deadline: July 15, 1996.

Purpose: To assist State Agency Maternal and Child Health and

Children with Special Health Care Need programs in the development of a

State and community infrastructure that results in comprehensive,

community-based systems of care for all children and their families.

Projects must: (1) support systems development activities identified in

the Title V MCH Block Grant application; (2) collaborate with CISS,

Healthy Start, and the Primary Care Cooperative Agreement; (3)

collaborate with other system development initiatives, such as, mental

health and education; (4) build on systems already in place; (5) and

make an effort to sustain systems development activities in the Title V

agency.

Priorities: Priority for funding will be given to projects in the

following areas:

--Establishing an integrated data management system which meets user

needs at the local, State, and national levels and is electronically

accessible.

--Supporting community-level planning for establishing priorities,

policies, and strategies for systems development.

--Improving collaborative partnerships for integrating health services.

--Initiating collaborative partnerships for integrating health with

other services, e.g., education, mental health, and social services.

--Promoting service systems that are family-centered and culturally

competent.

--Developing a mechanism for assuring quality performance and

utilization of community systems.

--Strengthening the skills, knowledge, and ability of state and

community leaders to develop comprehensive community systems of care.

Special Eligibility Considerations: Eligibility for funding is

limited to the Title V agencies in the 50 States and 9 Jurisdictions.

Project Period: Three years.

Contact: Kay K. Guirl, R.N., M.N., Senior Public Health Analyst,

Division of Services for Children with Special Health Needs, 301 443-

2350.

5.1.3.2. Transition Services in Adolescent Health.

Application Deadline: May 15, 1996.

Purpose: To fund two categories of SPRANS projects which

support ongoing efforts to develop comprehensive, culturally competent,

community-based, family-centered, coordinated care systems for

adolescents with special health care needs and their families. The

funds are intended to help these adolescents achieve a successful

transition to community-based, comprehensive care and to maximize

potential for employment. The MCHB has identified the need for public

and private partnerships to improve the coordination of services to

assist and

[[Page 12080]]

support adolescents with disabilities. These efforts are based, in

part, on the work of the Federal SSI/CSHCN Workgroup, a collaborative

effort of the MCHB, the Social Security Administration (SSA), and State

Title V CSHCN Programs, which has identified barriers faced by

adolescents with special health needs; and the National Commission on

Childhood Disability, which, in its October, 1995, Report to Congress,

identified changes needed in the SSI Program to more effectively

promote self sufficiency of SSI child beneficiaries.

Another excellent example of ongoing collaboration, the CHOICES

Project is a public/private partnership jointly funded by the MCHB and

the Shriners Hospitals. CHOICES has strengthened cooperation between

Title V CSNCN programs, Shriners Hospitals, and Vocational

Rehabilitation programs and maximized services available to adolescents

with disabilities. The MCHB is seeking to build on the past efforts of

CHOICES, to strengthen systems of care for adolescents and

preadolescents with special health needs and encourage them to grow,

develop and make a successful transition to comprehensive care, work

and self sufficiency. Utilizing the resources of a broad spectrum of

health and social services providers, vocational training and

rehabilitation agencies, education and private employers, the

initiative will: (1) Identify and increase the understanding of the

needs and special problems of adolescents with disabilities in making

successful transitions to adult care, to be ``healthy and ready to

work'' and to achieve self sufficiency; (2) foster the development of

public and private partnerships and collaborative relationships that

will maximize the availability of and access to comprehensive,

community-based, coordinated care systems for adolescents with special

health needs and their families; and (3) improve the ability of

adolescents with disabilities to lead productive lives and maximize

financial independence.

Priorities/Funding Categories: Applications are being

accepted for two categories of projects in FY 1996. Applications which

do not fall within these program categories will not be considered.

--The Priority 1 funding category will support community-based planning

and initial development grants to strengthen community-based systems

that help adolescents with disabilities make successful transitions to

self sufficiency and work. The emphasis of this category is on support

for community level infrastructures of agencies, providers, community

organizations, business and families. Projects will focus on needs

assessment and local capacity-building, identifying and making maximum

use of all available public and private resources for reaching and

providing services to the target population. Services to transition

adolescents from child-centered to adult-based care are expected to

include primary, preventive, and specialty care that also addresses

psychosocial needs. Projects must involve targeted adolescents and

their families in needs assessment, as well as ongoing project planning

and development. Funding will support local capacity building for

planning, coordination of services, and care and financing systems

development. Collaboration must be evident with key public programs

within the community responsible for serving adolescents with special

needs and disabilities funded under Title V Maternal and Child Health

programs, vocational rehabilitation, education, mental health, social

services agencies, and the State's SSI Action Plan.

--The Priority 2 funding category will expand already established

regional and/or national efforts to support adolescents in making

successful transitions from hospital to ambulatory care, to be

``healthy and ready to work'' and to achieve independence. Priority 2

projects will have the same general goals as those defined in Priority

1; however Priority 2 applicants must have already completed planning

and initial development and have an existing infrastructure to achieve

project goals and objectives. This infrastructure must, at a minimum,

include selected State Title V CSHCN programs, Shriners Hospitals, and

Vocational Rehabilitation programs. Applicants must represent a public/

private partnership of Title V and a national hospital network which

serves significant numbers of adolescents with disabilities. In

addressing the goal of preparing adolescents to make transitions to

adult comprehensive care and independent living, the project must

involve community resources, including Vocational Rehabilitation,

education, and employers in order to identify appropriate work

opportunities and assure that adolescents have ongoing comprehensive

and coordinated health care coverage.

Special Eligibility Considerations: In keeping with the

September 15, 1995, report of the U.S. Senate Appropriations Committee

(S. Rep. 104-145), which urged continued MCHB support for the CHOICES

Project, special preference for Priority 2 grants will be given to

projects of similar scope and organization.

Project Period: One to two year awards for Priority 1

projects; one to three years for Priority 2 projects.

Contact: For programmatic or technical information,

contact Beth D. Roy, telephone 301 443-2370. A pre-application

conference call will be held on Thursday, April 18, at 2:00 p.m., EST.

Persons interested in participating should send a letter of interest,

including a brief description of their proposal and any issues they

wish to have addressed during the call, by Friday, April 5, to Beth

Roy, Room 18A-27, Parklawn Building, 5600 Fishers Lane, Rockville, MD

20857.

5.1.3.3. Universal Newborn Hearing Screening.

Application Deadline: May 17, 1996.

Purpose: To promote the establishment of statewide

universal newborn hearing screening programs in the United States

through a national network which (a) increases awareness of the

feasibility of newborn hearing screening, (b) provides technical

assistance on program establishment, maintenance, and coordination, and

(c) maintains and analyzes data to monitor and evaluate the impact of

universal newborn hearing screening programs. This priority responds to

the Healthy People 2000 objective (17.16) which calls for the reduction

in the average age at which children with significant hearing

impairment are identified to no more than 12 months.

Priorities: Priority for funding will be given to those

applications which address the following factors:

--Coordination of screening programs emphasizing linkages between

hospital screening programs, pediatricians, audiologists, state

agencies, and community services providers.

--Sustainability beyond the grant period emphasizing utilization of

local funding to establish and institutionalize programs as part of the

ongoing provision of health care services.

--Ongoing support and technical assistance for emerging programs

utilizing valid, cost effective, and feasible strategies and

instrumentation for the conduct of universal hearing screening.

--Impact of early screening, emphasizing outcome evaluation

[[Page 12081]]

which includes both quantitative and qualitative data on

identification, intervention, cost, and developmental outcomes for

young children.

Project Period: The project period is four years.

Contact: For programmatic or technical information,

contact Bonnie Strickland, Ph.D., 301/443-1080.

4.1.3.4. Data Utilization and Enhancement.

Application Deadline: June 17, 1996.

Purpose: To enhance the use of information and information

technologies within State and local MCH/CSHCN agencies and within the

MCH community in the development of policies, programs and evaluation

of services to improve the health and well being of mothers and all

children as outlined in the ``MCH Strategy Statement: Data Systems and

Enhancement.'' Activities in this initiative may include:

--Development of retrievable and usable information and model data

systems. The systems will be used in the collection, management, and

analysis of data to facilitate needs assessment, planning, program

implementation, monitoring, and evaluation of the health status of

mothers and children and the delivery of comprehensive health care to

that population.

--Linkage of and/or improvement of access to information among various

service and data systems. These may include administrative, clinical,

educational, communities and population information.

--Analysis of economic cost, benefits and effectiveness of services and

systems on the well being of the MCH community, particularly the high

risk and underserved portions of the population, including a

compilation of service cost impacts related to health outcomes, cost

benefit analysis of major MCH services, and dissemination of economic

information to the MCH community.

Work products may take a variety of forms, such as papers, models,

software, information services, stipends, and reports. Work products

will be directed to the MCH community, including all mothers and

children, and the service and system providers integral to providing

them with comprehensive, family centered, culturally competent,

community services.

Priorities: Proposals in this MCHIP subcategory are

invited in the following program areas:

--Development of model information systems with data that can be

retrieved, integrated, and used by others at national and State levels.

--Enhancement of information collection and analysis capabilities of

national, State and local health agencies using the models developed,

training, and peer consultation.

--Collection, management, and analysis of data, and development and

application of analytic and information management techniques focusing

on national MCH issues.

--Networking, coordination, and integration of existing and proposed

resources and data information technologies and analysis systems

developed by other States or organizations.

--Increasing national, State and local analytical and information

system capacity to respond to and implement changes in the organization

of health care resources.

--Dissemination of relevant programmatic and population information and

developed models to enhance access and utility for the MCH populations.

--Provision of direction and incentives to individuals in carrying out

the purpose of this initiative through partnerships with educational

institutions and State and local MCH agencies.

--Monitoring and assessing information and information technology

requirements parallel to organizational changes in delivery of health

care services to all mother and children.

Grants/Amounts: Up to 3 years, with declining Federal

funding and escalating local funding.

Contact: For programmatic or technical information,

contact Russ Scarato, telephone: 301 443-8041.

5.1.3.5. Healthy Tomorrows Partnerships for Children.

Application Deadline: May 13, 1996.

Purpose: To support projects for mothers and children that

improve access to health services and utilize preventive strategies.

The initiative encourages additional support from the private sector

and from foundations to form community-based partnerships to coordinate

health resources for pregnant women, infants and children.

Priorities: Proposals in this MCHIP category are invited

in the following program areas:

--Local initiatives that are community-based, family-centered,

comprehensive and culturally relevant and improve access to health

services for infants, children, adolescents, or CSHCN.

--Initiatives which show evidence of a capability to meet cost

participation goals by securing funds for the second and sequential

years of the project.

Special Eligibility Considerations: In the interest of

equitable geographic distribution, special consideration for funding

will be given to projects from States without a currently funded

project in this category. These States are cited in the application

guidance.

Project Period: Five years.

Contact: For programmatic or technical information,

contact Latricia Robertson, M.S.N., M.P.H., telephone: 301 443-8041.

5.2. Cooperative Agreements

Cooperative agreements will be awarded in four categories: Maternal

and Child Health Providers Partnership; Partnership for Information and

Communication; Fetal/Infant Mortality Review Program Support Center;

and Partnership for Adolescent Health.

There will be substantial Federal programmatic involvement in these

cooperative agreements. This means that after award, awarding office

staff provide technical assistance and guidance to, or coordinate and

participate in, certain programmatic activities of award recipients

beyond their normal stewardship responsibilities in the administration

of grants. Federal involvement may include, but is not limited to,

planning, guidance, coordination and participation in programmatic

activities. Periodic meetings, conferences, and/or communications with

the award recipient are held to review mutually agreed upon goals and

objectives and to assess progress. Additional details on the scope of

Federal programmatic involvement in cooperative agreements, consistent

with HRSA grants administration policy, will be included in the

application guidance for these cooperative agreements.

5.2.1. Maternal and Child Health Providers Partnership

Application Deadline: June 1, 1996.

Purpose: To support activities which improve access and

the delivery of maternal and child health services through governmental

and professional partnerships. Specifically, the program is designed to

promote problem-solving approaches which enhance community and provider

participation. This provider partnership will encourage private sector

and other support for improved coordination of and access to health

resources at the community-level for pregnant women, infants and

children.

[[Page 12082]]

Any national membership organization able to demonstrate that it

represents a group(s) of providers of pediatric services will be

considered for funding.

Specific program requirements include:

--Analysis of the obstacles (issues and contributing factors) to

provider participation in the delivery of maternal and child health

services to low-income pregnant women and children, as well as

involvement in problem solving at the community level.

--Development of strategies to improve maternal and child health status

and systems through collaboration with the Federal MCHB which promote

problem solving at the community level; encourage provider

participation; and encourage private sector and other support for

improved coordination of and access to health resources at the

community level.

--Dissemination and effective communication of concerns and information

pertaining to the issues and strategies employed to their members and

other national organizations.

Project Period: Up to 5 years.

Contact: For programmatic or technical information,

contact Latricia Robertson, M.S.N., M.P.H., telephone: 301-443-8041.

5.2.2. Partnership for Information and Communication (PIC)

Application Deadline: June 15, 1996.

Purpose: To facilitate dissemination of new maternal and

child health-related information to policy and decision makers in a

format most useful to them and provide those individuals with a means

of communicating issues directly to each other and to MCHB. This is a

continuous Bureau activity with a single priority--to enhance

communication between the MCHB and governmental, professional and

private organizations representing leaders and policy makers concerned

with issues related to maternal and child health. Organizations

currently receiving support as part of this cooperative agreement

represent State governors and their staffs; State Title V programs;

State legislators; private business, particularly self-insured

businesses; philanthropic organizations; and parent organizations, as

well as national membership organizations representing groups or

constituencies listed below.

To ensure continuity, membership for the organizations

participating in PIC is rotated so that not all project periods

coincide. For this year, only national membership organizations

representing the following groups will be considered for funding:

--County health policymakers.

--Municipal health policymakers.

Project Period: Up to 5 years.

Contact: For programmatic or technical information,

contact David Heppel, M.D., telephone: 301-443-2250.

5.2.3. Fetal/Infant Mortality Review Program Support Center

Application Deadline: June 14, 1996.

Purpose: To provide technical support to States and

communities as they develop and implement community-based fetal/infant

mortality review process. Fetal/Infant Mortality Review (F/IMR) is a

process that identifies, through use of a community multidisciplinary

team, community health care system, economic and social factors that

may have contributed to an infant death. These findings are then used

by the community to address the identified contributing factors and to

promote local program development.

The Center will be responsible for working with the MCHB to promote

the F/IMR process, provide assistance in setting up the process, share

pertinent information among communities and States, develop refinements

and new approaches to the F/IMR process to make it more responsive and

efficient, and expand the use of this problem-solving to other

mortality and morbidity events impacting the MCH population.

Project Period: Up to five years.

Contact: For programmatic or technical information,

contact David Heppel, M.D., telephone: 301-443-2250.

5.2.4. Partnership for Adolescent Health

Application Deadline: June 14, 1996.

Purpose: To collaborate with membership organizations having an

historic interest in adolescent health in seeking policy guidance from

and providing programmatic information to their memberships. This

cooperative agreement stems from Congress's mandate to the Department,

in section 1708 of the Public Health Service Act, to create an Office

of Adolescent Health (OAH). The functions of the OAH are delegated to

the MCHB. Fulfilling the need for a focal point for adolescent health,

the OAH is responsible for assisting private and other public

organizations to develop a collaborative approach to planning,

implementing, monitoring and evaluating national programs to promote,

improve and maintain the health status of pre-adolescents and

adolescents.

Priorities: For purposes of this competition, only membership

organizations representing the following disciplines will be considered

for funding:

--Law.

--Social Work.

--Psychology.

--Medicine.

Future competitions will be focused on other professional

disciplines.

Project Period: Up to 5 years.

Contact: For programmatic or technical information contact Juanita

C. Evans, LCSW, telephone: 301 443-4026.

6. Public Comment

The categories, priorities, special considerations and preferences

described above are not being proposed for public comment this year. In

July 1993, following publication of the Department's Notice of Proposed

Rulemaking to revise the MCH special project grant regulations at 42

CFR part 51a, the public was invited for a 60-day period to submit

comments regarding all aspects of the SPRANS application and review

process. In responding to those comments, the Department noted the

practical limits on Secretarial discretion in establishing SPRANS

categories and priorities owing to the extensive prescription in both

the statute and annual Congressional directives.

Comments on this SPRANS notice which members of the public wish to

make are welcome at any time and may be submitted to: Director, MCHB,

at the address listed in the ADDRESS section. Suggestions will be

considered when priorities are developed for the next solicitation.

7. Eligible Applicants

Any public or private entity, including an Indian tribe or tribal

organization (as defined at 25 U.S.C. 450b), is eligible to apply for

grants or cooperative agreements for project categories covered in this

announcement.

8. Public Health System Reporting Requirements

This program is subject to the Public Health System Reporting

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

requirements, the community-based nongovernmental applicant must

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

PHSIS is intended to provide information to State and local health

officials to keep them apprised of proposed health services grant

[[Page 12083]]

applications submitted by community-based nongovernmental organizations

within their jurisdictions.

Community-based nongovernmental applicants are required to submit

the following information to the head of the appropriate State and

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

Federal application receipt due date:

(a) A copy of the face page of the application (SF 424).

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

provides:

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

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

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

State and local health agencies.

The project abstract may be used in lieu of the one-page PHSIS, if

the applicant is required to submit a PHSIS.

9. Executive Order 12372

The MCH Federal set-aside program has been determined to be a

program which is not subject to the provisions of Executive Order 12372

concerning intergovernmental review of Federal programs.

The OMB Catalog of Federal Domestic Assistance number is 93.110.

Dated: March 19, 1996.

Ciro V. Sumaya,

Administrator.

[FR Doc. 96-7106 Filed 3-22-96; 8:45 am]

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