Office of Minority Health; Availability of Funds for Grants for the Minority Community Health Coalition Demonstration Program

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

Office of Minority Health; Availability of Funds for Grants for

the Minority Community Health Coalition Demonstration Program

AGENCY: Office of the Secretary, Office of Minority Health.

ACTION: Notice of availability of funds and request for applications

for the Minority Community Health Coalition Demonstration Grant

Program.

Authority

This program is authorized under section 1707(d)(1) of the Public

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

Minority Improvement Act of 1990.

Purpose

The purpose of this Fiscal Year 1998 Minority Community Health

Coalition Demonstration Program is to issue grants to improve the

health status of targeted minority populations through health promotion

and disease risk reduction intervention programs. This program is

intended to demonstrate the effectiveness of community-based coalitions

in:

(1) Developing, implementing and conducting demonstration projects

which coordinate integrated community-based screening and outreach

services, and include linkages for access and treatment to minorities

in high-risk, low-income communities; and

(2) Addressing sociocultural and linguistic barriers to health

care.

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 to reduce morbidity and mortality and

to improve the quality of life. Potential applicants may obtain a copy

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

Healthy People 2000 Midcourse Review and 1995 Revisions (Stock No. 017-

001-00526-6) through the Superintendent of Documents, Government

Printing Office, Washington, D.C. 20402-9325 or telephone (202) 783-

8238.

Background

This program is based on the hypothesis that the community

coalition approach to health promotion and risk reduction can be

effective in reaching minority target populations--especially those

most at risk or hard to reach. Among the merits of using coalitions is

the higher likelihood that: (1) the intervention will be culturally

sensitive, credible and more acceptable to the target population; (2)

the project will address the health problem(s) within the context of

related socio-economic issues; and (3) the effort will contribute to

overall community empowerment by strengthening indigenous leadership

and organizations. The OMH is continuing, through this announcement, to

promote the utilization of community coalitions to develop and

implement health promotion/disease risk reduction programs.

In FY 1998 the Minority Community Health Coalition Demonstration

Program continues to focus on health problem areas identified in the

1995 OMH Report to Congress. These health areas are commonly referred

to as the ``7+4'' health issue areas: (1) cancer; (2) cardiovascular

disease and stroke; (3) chemical dependency; (4) diabetes; (5)

homicide, suicide and unintentional injuries; (6) infant mortality; and

(7) HIV/AIDS; plus, access to health care; health professions personnel

development; improved data collection and analysis; and cultural

competency. Flexibility for communities to define their own health

problem priorities (e.g., asthma, sexually transmitted diseases [STDs],

tuberculosis, female genital mutilation, immunization and tobacco use)

is also encouraged.

Eligible Applicants

Public and private, nonprofit minority community-based

organizations which represent an established community coalition of at

least three discrete organizations. (See Definitions of Minority

Community-Based Organizations and Community Coalition found in this

announcement.) The minority community-based organization will: serve as

the lead agency for the grant; be responsible for management of the

project; and serve as the fiscal agent for the Federal grant awarded.

The coalition must include a health care facility such as a community

health center, migrant health center, health department or medical

center to provide follow-up treatment services. The coalition

membership must be documented as specified under the project

requirements described in this announcement.

National organizations are not eligible to apply, however, local

affiliates of such organizations which meet the definition of minority

community-based organization are eligible. Currently funded OMH

Bilingual/Bicultural Service Demonstration Program (Managed Care)

grantees are not eligible to apply. Organizations are not eligible to

receive funding from more than one OMH grant program.

Deadline

To receive consideration, grant applications must be received by

the Office of Minority Health (OMH) Grants Management Office by January

20, 1998. Applications will be considered as meeting the deadline if

they are: (1) received on or before the deadline date, or (2)

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

orderly processing. A legibly dated receipt from a commercial carrier

or U.S. Postal Service will be accepted in lieu of a postmark. Private

metered postmarks will not be accepted as proof of timely mailing.

Applications submitted by facsimile transmission (FAX) or any other

electronic format will not be accepted. Applications which do not meet

the deadline will be considered late and will be returned to the

applicant unread.

Addresses/Contacts

Applications must be prepared using Form PHS 5161-1 (Revised July

1992 and approved by OMB under control Number 0937-0189). Application

kits and technical assistance on budget and business aspects of the

application may be obtained from Ms. Carolyn A. Williams, Grants

Management Officer, Division of Management Operations, Office of

Minority Health, Rockwall II Building, Suite 1000, 5515 Security Lane,

Rockville, MD 20852, telephone (301) 594-0758. Completed applications

are to be submitted to the same address.

Questions regarding programmatic information and/or requests for

technical assistance in the preparation of grant applications should be

directed to Ms. Cynthia H. Amis, Director, Division of Program

Operations, Office of Minority Health, Rockwall II Building, Suite

1000, 5515 Security Lane, Rockville, MD 20852, telephone (301) 594-

0769.

Technical assistance is also available through the OMH Regional

Minority Health Consultants (RMHCs). A listing

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of the RMHCs and how they may be contacted will be provided in the

grant application kit. Additionally, applicants can contact the OMH

Resource Center (OMH-RC) at 1-800-444-6472 for health information.

Availiability of Funds

Approximately $2.5 million is expected to be available for award in

FY 1998. It is projected that awards of up to $150,000 total costs

(direct and indirect) for a 12 month period will be made to

approximately 16 to 18 competing applicants. Of the total amount

obligated, at least $750,000 will be awarded to projects that include

HIV/AIDS as one of the targeted health problem areas.

Period of Support

The start date for the Minority Community Health Coalition

Demonstration Program grants is July 1, 1998. Support may be requested

for a total project period not to exceed 3 years. Noncompeting

continuation awards of up to $150,000 will be made subject to

satisfactory performance and availability of funds.

Project Requirements

Each applicant to this demonstration grant program must:

(1) Address at least one, but no more than three (3) health problem

areas which significantly impact the local targeted community. At least

one must be from Part A (``7+4'') of the definition of health problem

area found in this announcement.

(2) Have an established coalition capable of ensuring that the

target population is provided with a continuum of appropriate health

care services and support. The coalition must have the capacity to plan

and coordinate services which reduce existing sociocultural and/or

linguistic barriers to health care and carry out screening, outreach

and enabling services to ensure that clients follow up with treatment

and treatment referrals.

(3) Detail/specify the roles and resources that each coalition

member will bring to the project, and state the duration and terms of

the agreement, as confirmed by a signed agreement between the applicant

organization and each coalition member. The document must be signed by

individuals with the authority to represent the organization (e.g.,

president, chief executive officer, executive director).

Use of Grant Funds

Budgets of up to $150,000 total cost (direct and indirect) per year

may be requested to cover costs of: personnel, consultants, supplies

(including screening and outreach supplies), equipment, and grant

related travel. Funds may not be used for medical treatment,

construction, building alterations, or renovations. All budget requests

must be fully justified in terms of the proposed goals and objectives

and include a computational explanation of how costs were determined.

Criteria for Evaluating Applications

Review of Application

Applications will be screened upon receipt. Those that are judged

to be incomplete, nonresponsive to the announcement or nonconforming

will be returned without comment. Each organization may submit no more

than one proposal under this announcement. If an organization submits

more than one proposal, all will be deemed ineligible and returned

without comment. Accepted applications will be reviewed for technical

merit in accordance with PHS policies. Applications will be evaluated

by an Objective Review Panel chosen for their expertise in minority

health, experience relevant to this program, and their understanding

and knowledge of the health problems and risk factors confronting

racial and ethnic minorities in the United States.

Applications are advised to pay close attention to the specific

program guidelines and general instructions provided in the application

kit.

Application Review Criteria

The technical review of applications will consider the following

generic factors, which are listed in descending order of priority.

Factor 1: Methodology (35%)

Appropriateness of proposed approach and specific activities for

each objective. Logic and sequencing of the planned approaches in

relation to the objectives and program evaluation. Extent to which the

applicant demonstrates access to the target population. Soundness of

the established linkages.

Factor 2: Evaluation (20%)

Thoroughness, feasibility and appropriateness of the evaluation

design, and data collection and analysis procedures. Potential for

replication of the project for similar target populations and

communities.

Factor 3: Background (15%)

Adequacy of demonstrated knowledge of the problem at the local

level; demonstrated need within the proposed community and target

population; demonstrated support and established linkages in order to

conduct proposed model; and extent and documented outcome of past

efforts/activities with the target population.

Factor 4: Goals and Objectives (15%)

Merit of the objectives, their relevance to the program purpose and

stated problem, and their attainability in the stated time frames.

Factor 5: Management Plan (15%)

Applicant organization's capability to manage and evaluate the

project as determined by: the qualifications of proposed staff or

requirements for ``to be hired'' staff; proposed staff level of effort;

management experience of the lead agency; and experience of each

coalition member as it relates to its defined roles and the project.

Award Criteria

Funding decisions will be determined by the Deputy Assistant

Secretary for Minority Health, Office of Minority Health and will take

under consideration: recommendations/ratings of the review panels;

geographic and racial/ethnic distribution; and health problem areas

having the greatest impact on minority populations. Consideration will

also be given to projects proposed to be implemented in Empowerment

Zones and Enterprise Communities.

Definitions

For purposes of this grant announcement, the following definitions

are provided:

Community-Based Organization--Public and private, non-profit

organizations which are representative of communities or significant

segments of communities, and which address health and human services.

Community Coalition--At least three (3) discrete organizations and

institutions in a community which on specific community concerns,

resolution of those concerns through a formalized relationship

documented by written memoranda of understanding/agreement signed by

individuals with the authority to represent the organizations (e.g.,

president, chief executive officer, executive director).

Cultural Competency--A set of interpersonal skills that allow

individuals to increase their understanding and appreciation of

cultural differences and similarities within, among and between groups.

This requires a willingness and ability to draw on community-based

values, traditions and customs, and to work with knowledgeable persons

of and

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from the community in developing focused interventions, communications

and other supports. (Orlandi, Mario A., 1992)

Health Care Facility--A public nonprofit facility that has an

established record for providing comprehensive health care services to

a targeted, racial/ethnic minority community. Facilities providing only

screening and referral activities are not included in this definition.

A health care facility may be a hospital, outpatient medical facility,

community health center, migrant health center, or a mental health

center.

Health Problem Area--(a) One of the ``7 + 4'' health areas: cancer,

cardiovascular disease and stroke; chemical dependency; diabetes;

homicide, suicide and unintentional injuries; infant mortality; HIV/

AIDS; access to health care; health professional personnel development;

improved data collection and analysis; and cultural competency; or (b)

a disease or health condition which has a demonstrated impact on

morbidity rates among the minority population, for example, asthma,

sexually transmitted diseases (STDs), tuberculosis, female genital

mutilation, immunization and tobacco use.

Intervention--A combination of clinical preventive services (e.g.,

blood pressure screening), information dissemination, environmental

modifications, educational activities, and coordinated networking

activities among health and human service related programs (e.g.,

referral for child care services, job placement, literacy programs)

designed to alter or modify a condition or outcome, or to change

behavior to reduce the likelihood of a preventable health problem

occurring or progressing further.

Minority Community-Based Organizations--Public and private

nonprofit community-based minority organization or a local affiliate of

a national minority organization that has: a governing board composed

of 51 percent or more racial/ethnic minority members, a significant

number of minorities in key program positions, and an established

record of service to a racial/ethnic minority community.

Minority Populations--American Indian or Alaska Native, Asian,

Black or African American, Hispanic or Latino, and Native Hawaiian or

Other Pacific Islander. (OMB Statistical Policy Directive No. 15)

Risk Factor--The environmental and behavioral influences capable of

causing ill health with or without predisposition.

Sociocultural Barriers--Policies, practices, behaviors and beliefs

that create obstacles to health care access and service delivery (e.g.,

immunization requirements, cultural differences between individuals and

institutions, cultural differences of beliefs about health and illness,

customs and lifestyles, cultural differences in languages or nonverbal

communication styles).

Reporting and Other Requirements

General Reporting Requirements

A successful applicant under this notice will submit: (1) semi-

annual progress reports; (2) an annual Financial Status Report; and (3)

a final progress report and Financial Status Report in the format

established by the Office of Minority Health, in accordance with

provisions of the general regulations which apply under CFR 74.50-

74.52, with the exception of State and local governments to which 45

CFR Part 92, Subpart C reporting requirements apply.

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

Recipients of PHS Grants

The Public Health Service strongly encourages all grant recipients

to provide a smoke-free workplace and to 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.

Public Health System Reporting Requirements

This program is subject to Public Health Systems Reporting

Requirements. Under these requirements, a 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 applications submitted by community-

based organizations within their jurisdictions.

Community-based nongovernmental applicants are required to submit,

no later than the Federal due date for receipt of the application, the

following information to the head of the appropriate State and local

health agencies in the area(s) to be impacted: (a) a copy of the face

page of the application (SF 424), and (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, and (3) a description of the coordination planned with the

appropriate State or local health agencies. Copies of the letters

forwarding the PHSIS to these authorities must be contained in the

application materials submitted to the Office of Minority Health.

State Reviews

This program is subject to the requirements of Executive Order

12372 which allows States the option of setting up a system for

reviewing applications from within their States for assistance under

certain Federal programs. The application kit to be made available

under this notice will contain a listing of States which have chosen to

set up a review system and will include a State Single Point of Contact

(SPOC) in the State for review. Applicants (other than federally

recognized Indian tribes) should contact their SPOCs 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. The due date for State process

recommendations is 60 days after the application deadline established

by the Office of Minority Health's Grants Management Officer. The

Office of Minority Health does not guarantee that it will accommodate

or explain its responses to State process recommendations received

after that date. (See ``Intergovernmental Review of Federal Programs''

Executive Order 12372 and 45 CFR Part 100 for a description of the

review process and requirements).

OMB Catalog of Federal Domestic Assistance

The OMB Catalog of Federal Domestic Assistance number for the

Minority Community Health Coalition Demonstration Program is 93-137.

Clay E. Simpson, Jr.,

Deputy Assistant Secretary for Minority Health.

[FR Doc. 97-30565 Filed 11-20-97; 8:45 am]

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