Availability of Funds for Grants for the Minority Community Health Coalition Demonstration Program, HIV/AIDS

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, HIV/AIDS

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, HIV/AIDS.

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Purpose

The purpose of this Fiscal Year 1999 Minority Community Health

Coalition Demonstration Grant Program, HIV/AIDS is to improve the

health status, relative to HIV/AIDS, of targeted minority populations

through health promotion and education activities. This program is

intended to demonstrate the effectiveness of community-based coalitions

involving non-traditional partners in:

(1) Developing an integrated community-based response to the HIV/

AIDS crisis through community dialogue and interaction;

(2) Addressing sociocultural, linguistic and other barriers to HIV/

AIDS treatment to increase the number of individuals seeking and

accepting services; and

(3) Developing and conducting HIV/AIDS education and outreach

efforts for hardly reached populations.

The overall goal is to increase the health status of minority

populations by increasing the educational understanding of HIV/AIDS,

increased testing, and improving the access to HIV/AIDS prevention and

treatment services.

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 of setting priority areas. This

announcement, the Minority Community Health Coalition Demonstration

Grant Program, HIV/AIDS, is related to four of the 22 priority areas

(1) Alcohol and other drugs; (2) educational and community-based

programs; (3) HIV Infection; and (4) sexually transmitted diseases.

Potential applicants may obtain a copy of Health People 2000 (Full

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

Report: Stock No. 017-001-0473-1) through the Superintendent of

Documents,

[[Page 33084]]

Government Printing Office, Washington, DC 20402-9325 or telephone

(202) 783-3238.

Background

The Minority Community Health Coalition Demonstration Grant

Program, HIV/AIDS is based on the hypothesis that the community

coalition approach to health promotion and education activities can be

effective in reaching minority target populations--especially those

most at risk or hardly reached. Among the merits of using coalitions is

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

linguistically competent, credible and more acceptable to the target

population; (2) the project will address HIV/AIDS 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/education activities to specifically focus

on HIV/AIDS. The OMH is also interested in involving those

organizations in the coalition that have not traditionally been

involved in HIV/AIDS prevention activities or services and outreach

(e.g., sororities/fraternities, rotary clubs, religious affiliates) so

that hardly reached populations (e.g. inmates, homeless, women at risk,

youth) are provided the services they need. By including organizations

that have not traditionally been involved in HIV/AIDS activities, the

community coalition will expand its network and ability to access and

serve these hardly reached populations. Applicants are also encouraged

to establish linkages with other federally funded programs supporting

HIV prevention and care to maximize these efforts.

Disproportionate Effect of HIV/AIDS on Minorities

Current statistics from the Centers for Disease Control and

Prevention (CDC) indicate that Blacks and Hispanics are

disproportionately represented among the more than 640,000 people with

AIDS that have been reported in the United States. While Blacks and

Hispanics respectively represent approximately 13% and 10% of the U.S.

population, 45% of people with AIDS reported in 1997 were Black and 21%

were Hispanic. Asian/Pacific Islanders and Native Americans

respectively represent 4% and 1% of the U.S. population and currently

each account for 1% of people with AIDS. During 1997, the rate of new

AIDS cases per 100,000 population in the U.S. was 83.7 among Blacks,

37.7 among Hispanics, 10.4 among whites, 10.4 among American Indians/

Alaska Natives, and 4.5 among Asians/Pacific Islanders. Although Asian/

Pacific Islanders and Native Americans do not appear to be

disproportionately affected by HIV infection, it is believed that the

low rate may be due in part to undercounting issues, especially in the

Native American population.

The behaviors that increase the risk of infection with HIV include:

unprotected sexual intercourse; the sharing of HIV infected needles or

other drug paraphernalia; and having numerous unprotected sexual

partners (homosexual or heterosexual). People who engage in more than

one of these behaviors, for example, individuals who have unprotected

sex with someone who injects drugs and shares needles or other

``works'', are at especially high-risk. HIV infections associated with

use of injected drugs involve not only drug users themselves, but their

sex partners and infants as well. Users of non-injected drugs, e.g.

crack, who sell sexual favors to support their habit often expose

themselves to multiple potentially infected partners.

Surveillance data shows that a large proportion of AIDS cases among

minorities are diagnosed in the 20 to 29 year old age group, indicating

HIV infection in adolescence or early 20's. Given the data regarding

the incidence of the disease among teenagers, adolescents and adults,

it is imperative to conduct targeted outreach activities to implement

comprehensive HIV/AIDS prevention and education programs in racial/

ethnic communities to reach these populations.

HIV/AIDS and Sexually Transmitted Diseases (STDs)

The behaviors which place individuals at risk for other STDs also

increase a person's risk of becoming infected with HIV. Prevention

through individual behavior change is the only method currently

available to stop the spread of HIV infection. According to the CDC,

biological studies suggest both increased susceptibility to HIV

infection and increased likelihood of infecting other people when STDs

are present. STD surveillance can provide important indications of

where HIV infection may spread, and where efforts to promote safer

sexual behaviors should be targeted. Therefore, it is important that

HIV education and prevention programs integrate STDs as health care

problems associated with the high-risk behaviors underlying HIV

transmission.

Eligible Applicants: Public and private, nonprofit minority

community-based organizations which represent a community coalition of

at least three discrete organizations (see definitions of Minority

Community-Based Organizations, Community Coalition and AIDS Service

Organization found in this announcement.) The applicant and at least

one of the three organizations must have significant experience in

conducting HIV/AIDS education, prevention and outreach activities. As

the applicant, the minority community-based organization must have at

least five years or more experience in HIV/AIDS. One of the three

organizations must be an AIDS Service Organization (ASO) with at least

three years of experience. Additionally, at least one of the coalition

members must be an organization rooted in the community, but with

limited experience conducting HIV/AIDS programs.

In order to maximize the use of the limited resources available for

this program and to address efforts where the HIV/AIDS problem is most

prevalent, eligible applicants must be located in one of the following

15 metropolitan statistical areas. These are the areas indicated by the

CDC in its HIV/AIDS Surveillance Reports for 1996 and 1997 as having

the highest number of newly reported AIDS cases in 1995, 1996 and 1997.

Atlanta, GA

Baltimore, MD

Boston, MA

Chicago, IL

Dallas, TX

Ft. Lauderdale, FL

Houston, TX

Los Angeles, CA

Miami, FL

New York, NY

Newark, NJ

Philadelphia, PA

San Francisco, CA

San Juan, PR

Washington, DC

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

membership must be documented as specified under the project

requirements described in this announcement.

National organizations, universities and schools of higher learning

are not eligible to apply. However, local affiliates of national

organizations which meet the definition of a minority community-based

organization are eligible. Currently funded OMH grantees are not

eligible to apply (e.g., Minority Community Health Coalition

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Demonstration Program, Bilingual/Bicultural Service Demonstration

Program). 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 July 21, 1999. 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 May 1996 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 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.

Availability of Funds: Approximately $2.5 million is to be

available for award in FY 1999. 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 13-15 competing applicants.

Period of Support: The start date for the Minority Community Health

Coalition Demonstration Program, HIV/AIDS grants is September 30, 1999.

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) Propose to conduct a replicable, model program using an

integrated community-based response to the HIV/AIDS crisis through

community dialogue and interaction designed to improve the health

status of targeted minority populations.

(2) Have a coalition capable of ensuring that the target population

is provided with HIV/AIDS health promotion and education outreach

activities that are linguistically, culturally and age appropriate

especially for hardly reached populations.

(3) Engage minority communities in activities that will impact

attitudes and perceptions in these communities to increase the number

of individuals seeking and accepting services.

(4) The coalition must consist of at least three discrete

organizations which include: (1) a minority community-based

organization; (2) an ASO; and, (3) one organization rooted in the

community with limited experience in HIV/AIDS activities. As the lead,

the minority community-based organization must have at least five years

of documented experience in conducting HIV/AIDS education and health

promotion activities. The coalition must include an ASO with at least

three years of documented experience to ensure that information

dissemination on HIV/AIDS and related issues is current and accurate

from a medical point of view. The coalition must also include at least

one organization rooted in the community that has not traditionally

been involved in HIV/AIDS activities.

(5) Provide signed documentation between the applicant and each

coalition member which specifies, in detail: (a) the roles and

resources that each entity will bring to the project, and (b) states

the duration and terms of the agreement. The document must be signed by

representatives with authority from all the member organizations

including the applicant (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, 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, non-responsive to the announcement or nonconforming

will be returned without comment. Each applicant 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.

Applicants 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.

Factor 1: Background (15%)

Adequacy of demonstrated knowledge of the problem at the local

level; demonstrated need within the proposed community and target

population; demonstrated support of local agencies and/or

organizations, and established linkages in order to conduct proposed

model; and extent and documented outcome of past efforts/activities

with the target population.

Factor 2: 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 3: Methodology (35%)

Appropriateness of proposed approach and specific activities for

each objective and target group. 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.

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Factor 4: Evaluation (20%)

Thoroughness, feasibility and appropriateness of the evaluation

design, and data collection and analysis procedures. Clarity of the

intent and plans to document the activities and their outcomes to

establish a model. The potential for replication of the project for

similar target populations and communities.

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 and

geographic and racial/ethnic distribution. Consideration will also be

given to projects proposed to be implemented in Empowerment Zones and

Enterprise Communities in the 15 eligible metropolitan statistical

areas and those which reach out to neighboring rural communities

impacted by the HIV/AIDS epidemic.

Definitions

For purposes of this grant announcement, the following definitions

are provided:

AIDS Service Organization (ASO)--A health association, support

agency, or other service actively involved in the prevention and

treatment of AIDS. (HIV/AIDS Treatment Information Service's Glossary

of HIV/AIDS-Related Terms, March 1997.)

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 collaborate on specific community

concerns, and seeks 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 behaviors, attitudes, and policies

that enable a system, agency, and/or individual to function effectively

with culturally diverse clients and communities. (Randall-David, E.,

1989)

Intervention--An activity or series of activities (e.g.,

information dissemination, educational activities, coordinated network-

related activities) 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 employed 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. (Revision to the Standards for the

Classification of Federal Data on Race and Ethnicity, Federal Register,

Vol. 62, No. 210, pg. 58782, October 30, 1997.)

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.,

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) 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.

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

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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).

Authority: This program is authorized under section 1707(e)(1)

of the Public Health Service Act, as amended by Public Law 105-392.

(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.)

Dated: June 9, 1999.

Nathan Stinson, Jr.,

Acting Deputy Assistant Secretary for Minority Health.

[FR Doc. 99-15635 Filed 6-18-99; 8:45 am]

BILLING CODE 4160-17-P