Cooperative Agreements To Support State; Assessment Initiatives

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 741]

Cooperative Agreements To Support State; Assessment Initiatives

Introduction

The Centers for Disease Control and Prevention (CDC), the Nation's

prevention agency, announces the availability of fiscal year (FY) 1997

funds for cooperative agreements to enhance State and local capacity to

assess progress toward achieving national, State, and community health

objectives; improve the capacity to conduct health assessment through

partnerships; and utilize assessment information for policy making and

program management.

CDC is committed to achieving the health promotion and disease

prevention objectives of Healthy People 2000, a national activity to

reduce morbidity and mortality and improve the quality of life. The

activities in this announcement are directly related to the priority

area of Surveillance and Data Systems in Healthy People 2000. (For

ordering a copy of Healthy People 2000, see the section Where to Obtain

Additional Information.)

Authority

This program is authorized under the Public Health Service Act,

Sections 301(a), 311(b), and 317 [42 U.S.C. 241(a), 243(b) and 247b],

as amended.

Smoke-Free Workplace

CDC strongly encourages all recipients to provide a smoke-free

workplace and promote the nonuse of all tobacco products, and Public

Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain

facilities that receive Federal funds in which education, library, day

care, health care, and early childhood development services are

provided to children.

Eligible Applicants

Eligible applicants are the official public health agencies of

States or their bona fide agents or instrumentalities and regional

consortia of such agencies. This includes the District of Columbia,

American Samoa, the Commonwealth of Puerto Rico, the Virgin Islands,

the Federated States of Micronesia, Guam, the Northern Mariana Islands,

the Republic of the Marshall Islands, and the Republic of Palau.

Note: Effective January 1, 1996, Section 18 of Public Law 104-65

states that an organization described in section 501(c)(4) of the

Internal Revenue Code of 1986 which engages in lobbying activities

shall not be eligible for the receipt of Federal funds constituting

an award, grant (cooperative agreement), contract, loan, or any

other form.

Availability of Funds

Approximately $1,335,000 is available in FY 1997 to fund

approximately 6-7 awards. It is expected that the average award will be

$200,000 ranging from $175,000 to $250,000. It is expected that the

awards will begin on or about September 30, 1997, and will be made for

a 12-month budget period within a project period of up to 5 years.

Funding estimates may vary and are subject to change. Continuation

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

satisfactory performance, an acceptable continuing application, and the

availability of funds.

If requested, Federal personnel may be assigned to a project in

lieu of a portion of the financial assistance.

Restrictions on Lobbying

Applicants should be aware of restrictions on the use of HHS funds

for

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lobbying of Federal or State legislative bodies. Under the provisions

of 31 U.S.C. Section 1352 (which has been in effect since December 23,

1989), recipients (and their subtier contractors) are prohibited from

using appropriated Federal funds (other than profits from a Federal

contract) for lobbying Congress or any Federal agency in connection

with the award of a particular contract, grant, cooperative agreement,

or loan. This includes grants/cooperative agreements that, in whole or

in part, involve conferences for which Federal funds cannot be used

directly or indirectly to encourage participants to lobby or to

instruct participants on how to lobby.

In addition, the FY 1997 HHS Appropriations Act, which became

effective October 1, 1996, expressly prohibits the use of 1997

appropriated funds for indirect or ``grass roots'' lobbying efforts

that are designed to support or defeat legislation pending before State

legislatures. This new law, Section 503 of Pub. L. No. 104-208,

provides as follows:

Sec. 503: (a) No part of any appropriation contained in this Act

shall be used, other than for normal and recognized executive-

legislative relationships, for publicity or propaganda purposes, for

the preparation, distribution, or use of any kit, pamphlet, booklet,

publication, radio, television, or video presentation designed to

support or defeat legislation pending before the Congress, . . .

except in presentation to the Congress or any State legislative body

itself.

(b) No part of any appropriation contained in this Act shall be

used to pay the salary or expenses of any grant or contract

recipient, or agent acting for such recipient, related to any

activity designed to influence legislation or appropriations pending

before the Congress or any State legislature.

Department of Labor, Health and Human Services, and Education, and

Related Agencies Appropriations Act, 1997, as enacted by the Omnibus

Consolidated Appropriations Act, 1997, Division A, Title I, Section

101(e), Pub. L. No. 104-208 (September 30, 1996).

Background

The ability of the public health system to assure the health of

Americans depends on its capacity to accomplish three major functions:

assessment, policy development, and assurance. The 1988 Institute of

Medicine Report, The Future of Public Health, emphasized the importance

of strengthening these core functions to respond to the public health

priorities of this decade. In addition to the three core functions, ten

public health practices have been determined as essential. Of the ten,

three of these practices relate to the assessment function (assess,

investigate, analyze), two focus on policy development (prioritize,

plan), and four address assurance (manage, implement, evaluate, and

inform/educate).

The Year 2000 Health Objectives are based on the three core

functions. Not only do the Year 2000 Objectives define the health

problems and measures that need to be monitored over time, they define

specific surveillance and data-system objectives that must be addressed

if public health agencies at all levels of government are to perform

the first of these major functions-- assessment.

During fiscal years 1992-1996, CDC awarded seven cooperative

agreements to State health departments to enhance their assessment

capacity. Since that time, important changes have affected the practice

of public health. Among these are:

Expansion of the managed care model in the health delivery

sector;

Recognition of local communities as the critical arena for

effective public health interventions;

Commitment to public health strategies founded on

partnerships between public and private organizations;

Movement for privatizing public health functions and

changing the respective roles of government agencies;

Emergence of new infectious diseases and other threats to

the health of the public;

Transfer of health policy-making responsibilities from the

Federal to State and local government;

Commitment by CDC and State and local public health

organizations to integrate information systems.

These influences provide the public health arena with new

challenges and opportunities when developing effective assessment

capacity at the State and community level. Chief among these is the

opportunity to strengthen the capacity to conduct comprehensive health

assessment through new partnerships with various public and private

entities.

Where assessment capacity is robust, integrated, and networked, its

practice enables community and State public health agencies-- in

partnership with other public and private organizations--to collaborate

in the collection, analysis, and use of information on a wide spectrum

of health matters, for example: (a) Vital statistics; (b) morbidity and

mortality related to infection, illness, chronic disease, injury and

disabilities; (c) personal, occupational, and environmental risk

factors; (d) the provision and effectiveness of public health programs

and health care services; (e) community perceptions of health problems

and priorities, and others. In most of the nation, however, assessment

capacity is not yet sufficiently developed to support that vision. Many

information systems serve only governmental public health agencies,

pass information from the community to State and Federal agencies, and

employ categorical or ``stand-alone'' electronic systems.

Strong assessment capacity is essential to determine health status

of target populations, establish priorities, develop effective health

policies, and evaluate the impact of public health and health care

programs. The ability of public health officials to carry out

assessment requires the following component:

1. Developing, maintaining, and using health information systems to

identify the impact of diseases, risk factors, and health care on the

population and to monitor changes in the impact, cost, quality, and

effectiveness over time.

2. Making health information available to State and local health

departments, Federal agencies, and other private and public users,

which enables health officials to define the health needs of a

population; to design and implement health prevention, health

promotion, and intervention programs; and to evaluate the effectiveness

of those programs.

3. Building the capacity of State and local health departments and

other relevant organizations to use integrated health information and

public health surveillance systems and to strengthen the core functions

of policy development and assurance.

4. Evaluating health information strategies, to determine their

adequacy in serving the health needs of communities and making

appropriate changes to maximize their effectiveness.

The ready exchange of data, information, knowledge, and expertise

among public health agencies and other public and private organizations

is critical to comprehensive health assessment. Recognizing this as an

essential objective, CDC initiated the Wide-Ranging Online Data for

Epidemiologic Research (WONDER)--a system of remote data base access

and electronic mail; and the Information Network for Public Health

Officials (INPHO)--infrastructure-building program.

Purpose

This project is intended to address health assessment capacity

building through the development of State public/private partnerships.

The

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purposes of this cooperative agreement are to:

A. Promote the development of innovative assessment partnerships

between traditional public health agencies and other public and private

partners.

B. Develop novel and creative approaches and methods of assessment

that will enhance State and local capacity to monitor progress toward

achieving measurable national, State, and community health objectives.

C. Strengthen the capacity to use information from assessment for

policy making, program management and coordination.

Funds will be awarded for developing assessment capacity in one or

more of the following four areas of emphasis. The objective of these

partnerships is to build the capacity of all partner agencies to use

health assessment information in policy development and program

management.

1. ``Managed Care Assessment Partnership'' associates State and

community public health agencies with health care provider

organizations operating under a capitated or other managed care model.

2. ``Collaborative Community Assessment Partnership'' combines

State and community public health agencies with local community-based

organizations (e.g., community health centers, community mental health

centers, Indian tribal clinics, nonprofit human services organizations,

schools, employers, and others).

3. ``Medicaid Assessment Partnership'' combines State and community

public health agencies with Medicaid agencies and organizations

affiliated with Medicaid agencies (e.g., health care providers under

contract to Medicaid agencies).

4. ``Preventive Health Assessment Partnership'' of State and

community public health agencies and other organizations (e.g.,

universities, schools of public health, academic health centers,

professional and voluntary organizations, Indian tribal governments,

philanthropic foundations, and businesses) that share an interest in

the health of a defined population and that can apply information,

resources, and other elements that are valuable to the goal of building

improved assessment capacity.

Program Requirements

In conducting activities to achieve the purposes of this program,

the recipient shall be responsible for the activities under A. below,

and CDC shall be responsible for conducting activities under B.

Applicant must apply for one or more of the partnership categories.

A. Recipient Activities

Year One

1. Develop a consortium of health partners to address the

assessment needs of the partnership. At least one of the following

partnership categories must be included: Managed Care Assessment

Partnership; Collaborative Community Assessment Partnership; Medicaid

Assessment Partnership; and Preventive Health Assessment Partnership.

2. Identify and describe project partners and their capacity to

provide assessment data and their skills and expertise in using data

for policy development and planning.

3. Form a project steering committee with representation from

consortium partners and hold, at minimum, quarterly meetings.

4. Determine the priority health assessment needs of the project

partners and the populations they serve.

5. Develop a five-year strategic plan for building assessment

capacity including: major goals and objectives; a description of major

data systems; ability of combining data from various system; data gaps;

modifications to current data systems; development of a combined

surveillance system to address identified health problems; roles and

responsibilities of all partners in the consortium; analysis plans;

data dissemination plans; and other relevant information.

6. Create or adopt health status indicators whose measurements and

use will become the objectives of the strategic plan.

7. Conduct an evaluation of each agency's surveillance/data systems

using the approach in the Guidelines for Evaluating Surveillance

Systems. Focus on only those systems that are relevant to the

indicators to be measured. (For obtaining a copy of Guidelines for

Evaluating Surveillance Systems, see the section Where to Obtain

Additional Information.)

Subsequent Years (Years 2-5)

8. Implement the strategic plan for building assessment capacity.

9. Develop and maintain a methodology for public health assessment,

including the flow, editing, analysis, and application of data.

10. Coordinate the health assessment system among partners and with

other appropriate organizational units in and out of the agency to

ensure consistency and comparability in the data that are collected and

to ensure a single point for data management.

11. Plan and implement procedures and training for ensuring the

timeliness, completeness, and quality of the data.

12. Develop and implement a plan for the analysis and use of health

assessment data in appropriate prevention and intervention programs to

reduce the prevalence of risk factors associated with identified health

problems.

13. Prepare and disseminate health assessment information through

presentation and publication in appropriate forums.

14. Develop an evaluation strategy to assess the effectiveness and

efficiency of the assessment practices used to monitor the health of

the population and provide reasonable evidence of the use of assessment

information in policy development and implementing changes in health

programs and priorities.

B. CDC Activities

1. Collaborate in the design and adoption of selected health status

indicators, standardized data items, definitions, procedures, and

methods to collect assessment information.

2. Provide training, as appropriate, on: public health assessment

and surveillance; analytic and methodological issues; electronic data

transfer; integration of laboratory data; and the uses of assessment

data for policy and planning.

3. Assist States to analyze, interpret, and use the health

assessment data to measure program effectiveness, improve

interventions, and formulate relevant policies.

4. Collaborate with the recipients in preparing and presenting

program-relevant findings to appropriate State and national audiences.

5. Collaborate with the recipients in evaluating the effectiveness

and efficiency of the health assessment system to monitor and intervene

upon the health risks of identified populations.

6. Review models, findings, and results of these projects and, in

collaboration with the recipients, compile and disseminate models of

improved capacity and practices for consideration and potential

adoption or adaptation in other jurisdictions.

Technical Reporting Requirements

Semiannual progress reports on project activities should be

submitted within 30 days after the end of each reporting period. An

original and two copies of a final performance report must be submitted

within 90 days after the end of the project period. These reports must

include:

A. A brief program description.

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B. A comparison of the actual accomplishments to the goals and

objectives established for the period.

C. If established goals and objectives were not accomplished or

were delayed, document both the reason for the deviation and the

anticipated corrective action, or rationale for deletion of the

activity from the project.

D. Other pertinent information, including the analysis of data

collected.

Financial status reports must be submitted no later than 90 days

after the end of each budget period. Final financial status reports are

required no later than 90 days after the end of the project period.

Application Content

Applicants are required to submit an original application and two

copies. Pages must be clearly numbered, and a complete index to the

application and its appendices must be included. Please begin each

separate section on a new page. The original and each copy of the

application set must be submitted unstapled and unbound. All material

must be typewritten, single-spaced, with unreduced type on 8\1/2\'' by

11'' paper, with at least 1'' margins, headers and footers, and printed

on one side only.

All applicants must develop their applications in accordance with

PHS Form 5161-1, information contained in this program announcement,

and the instructions outlined below. If the proposed program is a

multiple year project, the applicant should provide a detailed

description for each year. The application, excluding budget and

appendixes, should not exceed 30 pages.

Applicant must provide a narrative describing the following:

A. Executive Summary

Provide a clear, concise, and written summary of the following: (1)

Statement of need; (2) major goals, objectives, and activities of the

proposed project; (3) operational plan; (4) capability of applicant;

and (5) estimated cost of the project including the requested amount.

B. Table of Contents

C. Statement of Need

Describe the role of assessment in setting the State's public

health priorities developing agency policy and planning; the State's

current assessment capability; the State's relationship with potential

partners and how assessment is conducted; and how this project will

strengthen the capacity to conduct assessment activities.

D. Goals and Objectives

Establish and submit long-term (5 year) goals and short-term (1

year) objectives for the assessment activities included in the

application. Objectives must be specific, measurable, time-phased, and

feasible.

E. Operational Plan

1. Submit a plan to develop and expand assessment activities

through a consortium of health partners. At least one of the following

partnership categories must be included in the plan: Managed Care

Assessment Partnership; Collaborative Community Assessment Partnership;

Medicaid Assessment Partnership; or Preventive Health Assessment

Partnership.

2. Submit a time schedule for all activities to be carried out in

year one, including responsible staff for each activity.

3. Describe future years' activities and explain how the first year

will logically lead into program activities in subsequent years.

4. Describe procedures to disseminate information from the

assessment activities for policy development, program evaluation, and

research through presentation and publication in appropriate forums.

F. Capability

1. Identify and describe the availability of data and information

for the project from various potential partners.

2. Identify and describe the project staff, their qualifications

and experience in epidemiology, surveillance, statistical applications,

program management, policy development, health assessment, and

integrated electronic information systems. Include the curriculum vitae

and job descriptions for key project staff in the supporting materials

in the appendix.

3. Provide written commitments from the appropriate public/private

organization expected to support activities as a potential partner in

this project.

G. Project Evaluation

Submit a plan to evaluate the project that assesses the extent to

which:

1. The consortium or partnership has been a successful means of

conducting and strengthening assessment activities.

2. Data were used for policy development, program planning, and

evaluation of appropriate intervention programs.

3. Data were appropriately analyzed and disseminated through

periodic reports, presentations, and publication.

H. Budget

1. Line-item descriptive justification for personnel, travel,

supplies, and other services should be submitted. Applicant should be

precise about the purpose of each budget item as it relates to the

project.

2. If applicable, applicants requesting monies for contracts should

include the name of the person or firm to be contracted, a description

of the services to be performed, an itemized and detailed budget

including justification, the period of performance, and the method of

selection.

3. Funding levels for years two through five should be estimated.

I. Supporting materials

1. Curriculum vitae and job descriptions of key personnel.

2. Materials related to previous or current activities of State and

local, public and private, health agencies directed toward assessment.

3. Letters of endorsement and/or collaboration of participating

partners, as appropriate.

Evaluation Criteria (100 Points)

Applications will be reviewed and evaluated according to the

following criteria:

A. Potential for Public Health Impact (10 Points)

1. Evidence of the applicant's plans to improve its ability to

perform the assessment function in conjunction with outside public/

private partners.

2. Evidence of the applicant's ability to develop, implement,

evaluate, and use assessment activities to support effective program

policies and interventions.

3. Extent and availability of statewide health data and information

from a variety of public and private sources.

B. Capability (30 Points)

1. The extent and appropriateness of previous State health

department assessment and policy development efforts to monitor health

risks of general and high-risk populations.

2. The ability of the State to integrate information and data from

two or more existing public and/or private sources for program

development and evaluation.

3. Evidence of strong working relationships with the organizational

entities involved with this project.

4. Evidence that key project staff have experience in surveillance,

assessment, applied research, partnership development, electronic data

information systems, and policy-making.

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C. Project Design (55 Points Total)

1. Partnership Development (15 Points)

a. The extent to which the applicant describes the feasibility of

developing a partnership for assessment activities in one or more of

the following four areas (Extra points will not be awarded for

developing more than one partnership): Managed Care Assessment

Partnership; Collaborative Community Assessment Partnership; Medicaid

Assessment Partnership; and/or Preventive Health Assessment

Partnership.

b. The adequacy of procedures for selecting private/public

partners, target population and health problem areas.

c. The adequacy of the partnership structure to establish partner

concurrence, build consensus, address problem resolution, and carry out

project activities within the proposed time schedule.

2. Strategic Plan (25 Points)

a. The adequacy of the applicant's plans to develop and maintain a

working partnership for public health assessment and policy

development.

b. The objectives and activities are appropriate, feasible, and

time appropriate to the project.

c. The ability of the applicant's plans to be flexible and able to

incorporate additional partners, activities, etc., as emerging issues

warrant.

3. Program Evaluation (15 Points)

a. The extent to which the applicant proposes a strategy of ongoing

evaluation and feedback for this project.

b. The adequacy of the applicant's plans to evaluate the overall

effectiveness and success of this project.

D. Commitment (5 Points)

1. Evidence that the organizational positioning of this project is

conducive to accomplishing the stated purposes of this cooperative

agreement, including formal written commitments from appropriate

organizational entities that would be expected to support the project.

2. Evidence of the applicant's ability to continue the project

beyond established performance period.

E. Budget (Not Weighted)

The extent to which the applicant describes the total amount of

funds requested in each of the object class categories and clearly

links the budget items to objectives and activities proposed for the

budget period.

F. Human Subjects (Not Weighted)

Whether or not exempt from the Department of Health and Human

Services (DHHS) regulations, are procedures adequate for the protection

of human subjects? Recommendations on the adequacy of protections

include: (1) Protections appear adequate and there are no comments to

make or concerns to raise, (2) protections appear adequate, but there

are comments regarding the protocol,(3) protections appear inadequate

and there are concerns related to human subjects, or (4) disapproval of

the application is recommended because the research risks are

sufficiently serious and protection against the risks are inadequate as

to make the entire application unacceptable.

Executive Order 12372 Review

Applications are subject to Intergovernmental Review of Federal

Programs as governed by Executive Order (E.O.) 12372. E.O. 12372 sets

up a system for State and local government review of proposed Federal

assistance applications. Applicants should contact their State Single

Point of Contact (SPOC) as early as possible to alert them to the

prospective applications and receive any necessary instructions on the

State process. For proposed projects serving more than one State, the

applicant is advised to contact the SPOC of each affected State. A

current list of SPOCs is included in the application kit. If SPOCs have

any State process recommendations on applications submitted to CDC,

they should forward them to Sharron P. Orum, Grants Management Officer,

Grants Management Branch, Procurement and Grants Office, Centers for

Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE.,

Atlanta, Georgia 30305. The due date for State process recommendations

is 30 days after the application deadline date for new and competing

continuation applications. The granting agency does not guarantee to

``accommodate or explain'' for State process recommendations it

receives after that date.

Public Health System Reporting Requirements

This program is not subject to the Public Health System Reporting

Requirements.

Catalog of Federal Domestic Assistance Number

The Catalog of Federal Domestic Assistance number is 93.283.

Other Requirements

Paperwork Reduction Act

Projects that involve the collection of information from 10 or more

individuals and funded by the cooperative agreement will be subject to

review by the Office of Management and Budget (OMB) under the Paperwork

Reduction Act.

Human Subjects

If the proposed project involves research on human subjects, the

applicant must comply with the Department of Health and Human Services

Regulations, 45 CFR part 46, regarding the protection of human

subjects. Assurance must be provided to demonstrate that the project

will be subject to initial and continuing review by an appropriate

institutional review committee. The applicant will be responsible for

providing assurance in accordance with the appropriate guidelines and

form provided in the application kit. Should human subjects review be

required, the proposed work plan should incorporate time lines for such

development and review activities.

Women, Racial, and Ethnic Minorities

It is the policy of the Centers for Disease Control and Prevention

(CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR)

to ensure that individuals of both sexes and the various racial and

ethnic groups will be included in CDC/ATSDR-supported research projects

involving human subjects, whenever feasible and appropriate. Racial and

ethnic groups are those defined in OMB Directive No. 15 and include

American Indian, Alaskan Native, Asian, Pacific Islander, Black and

Hispanic. Applicants shall ensure that women, racial and ethnic

minority populations are appropriately represented in applications for

research involving human subjects. Where clear and compelling rationale

exist that inclusion is inappropriate or not feasible, this situation

must be explained as part of the application. This policy does not

apply to research studies when the investigator cannot control the

race, ethnicity and/or sex of subjects. Further guidance to this policy

is contained in the Federal Register, Vol. 60, No. 179, pages 47947-

47951, and dated Friday, September 15, 1995.

Application Submission and Deadline

The original and two copies of the application PHS Form 5161-1

(Revised 7/92, OMB Number 0937-0189) must be submitted to Sharron P.

Orum, Grants Management Officer, Grants Management Branch, Procurement

and Grants Office, Centers for Disease Control and Prevention (CDC),

255 East Paces Ferry Road, NE., Room 314, Mail Stop E-18, Atlanta,

Georgia 30305, on or before August 11, 1997.

[[Page 33660]]

1. Deadline: Applications shall be considered as meeting the

deadline if they are either:

(a) Received on or before the deadline date; or

(b) Sent on or before the deadline date and received in time for

submission to the objective review group. (Applicants must request a

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

receipt from a commercial carrier or the U.S. Postal Service. Private

metered postmarks shall not be acceptable as proof of timely mailing.)

2. Late Application: Applications that do not meet the criteria in

1.(a) or 1.(b) above are considered late applications. Late

applications will not be considered in the current competition and will

be returned to the applicant.

Where To Obtain Additional Information

To receive additional written information, call (404) 332-4561. You

will be asked to leave your name, address, and telephone number. Please

refer to Announcement 741. You will receive a complete program

description, information on application procedures, and application

forms. If you have questions after reviewing the contents of all the

documents, business management technical assistance may be obtained

from Albertha Carey, Grants Management Specialist, Grants Management

Branch, Procurement and Grants Office, Centers for Disease Control and

Prevention (CDC), 255 East Paces Ferry Road, NE., Room 314, Mail Stop

E-18, Atlanta, Georgia 30305, telephone (404) 842-6591; electronic mail

at [email protected].

Technical assistance may be obtained from Colette Zyrkowski,

Division of Public Health Surveillance and Informatics, Epidemiology

Program Office, Centers for Disease Control and Prevention (CDC), Mail

Stop C-08, 1600 Clifton Road, NE., Atlanta, Georgia 30333, telephone

(404) 639-0080; fax (404) 639-1546; or Internet or CDC WONDER

electronic mail at [email protected].

You may obtain this announcement from one of two Internet sites on

the actual publication date: CDC's homepage at http://www.cdc.gov or

the Government Printing Office homepage (including free on-line access

to the Federal Register at http://www.access.gpo.gov).

Please refer to Program Announcement 741 when requesting

information and submitting an application.

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) referenced in the ``Introduction''

through the Superintendent of Documents, Government Printing Office,

Washington, DC 20402-9325, telephone (202) 512-1800. Centers for

Disease Control and Prevention Guidelines for Evaluating Surveillance

Systems can be found in the Morbidity and Mortality Weekly Report 1988;

37 (suppl. no. S-5).

Dated: June 16, 1997.

Joseph R. Carter,

Acting Associate Director for Management and Operations, Centers for

Disease Control and Prevention (CDC).

[FR Doc. 97-16169 Filed 6-19-97; 8:45 am]

BILLING CODE 4163-18-P