National Health Promotion and Information Center for People With Paralysis (Christopher and Dana Reeve Paralysis Resource Center) Cooperative Agreement Information
[Federal Register: March 14, 1997 (Volume 62, Number 50)]
[Notices]
[Page 12208-12216] From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr14mr97-80]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
[Announcement Number 731]
Research Projects for Health Promotion for Persons With Disabilities and Prevention of Secondary Conditions; Notice of Availability of Funds for Fiscal Year 1997
Introduction
The Centers for Disease Control and Prevention (CDC) announces the availability of fiscal year (FY) 1997 competitive grant and cooperative agreement funds. Part 1 of this Announcement will support research grants to: (a) Measure the magnitude of secondary conditions in specified populations of persons who have a disability; (b) determine the risk and protective factors that contribute to or avert the occurrence of secondary conditions; (c) conduct and measure the effectiveness of health promotion interventions designed to prevent secondary conditions; and/or (d) understand the prevention effectiveness and cost-effectiveness of interventions. Part 2 of this Announcement will support one cooperative agreement project to prevent the occurrence of pressure sores and other selected secondary conditions among persons with spinal cord injury.
CDC is committed to achieving the health promotion and disease prevention objectives described in "Healthy People 2000," a national activity to reduce morbidity and mortality and improve the quality of life. This Announcement is related to the Healthy People 2000 category of Preventive Services. (For ordering a copy of "Healthy People 2000," see the section Where to Obtain Additional Information.)
Authority
This program is authorized by Section 301(a) (42 U.S.C. 241(a)) and Section 317 (42 U.S.C. 247b) of the Public Health Service Act, as amended.
Smoke-Free Workplace
CDC strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. 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 for this program are public and private non-profit entities, including universities; university-affiliated systems including not-for-profit medical centers; research institutions and rehabilitation hospitals; State health departments and other related State government agencies; disability service groups such as advocacy and voluntary organizations and independent living centers; and federally recognized Indian Tribal Governments.
Note: An organization described in section 501(c)(4) of the Internal Revenue Code of 1986 which engages in lobbying activities shall not be eligible to receive Federal funds constituting an award, grant, contract, loan, or any other form.
Availability of Funds
This Announcement has two separate components as noted in the INTRODUCTION section. Under Part 1, it is anticipated that approximately $1,800,000 will be available in FY 1997 to support 6 to 8 research grant projects, with an expected range of awards from $220,000 to $280,000 each. Under Part 2, it is estimated that approximately $250,000 will be available in FY 1997 to support one cooperative agreement to prevent the occurrence of pressure sores and other selected secondary conditions among persons with spinal cord injury. Awards are expected to be made on or before August 1, 1997, for a twelve-month budget period within a project period of up to three years. Funding estimates are subject to change, including funds to be awarded in continuation years based on documented progress toward objectives, the quality of continuation year work plans, evidence of cost-sharing, and the availability of funds.
This program has no statutory matching requirement. However, applicants should document their financial support for a portion of project costs, such as salaries for key staff and tangible contributions by collaborating agencies. Applicants should also demonstrate their capacity to increase cost-sharing over time, and identify other funding sources to assist in project activities.
Use of Funds
Grant funds may be used to support personnel services, supplies, equipment, travel, subcontracts, and other services directly related to project activities consistent with the approved scope of work. Project funds may not be used to supplant other available applicant or collaborating agency funds, for construction, for lease or purchase of facilities or space, or for patient care. Project funds may not be used for individualized preventive measures (direct patient support) such as for wheelchairs, medical appliances, or assistive technology unless specifically approved by the funding agency.
Purpose
The purpose of grant awards under Part 1 is to develop better understanding of the secondary conditions that occur among prescribed groups of persons with disabilities. These awards will allow grantees to measure the risk factors and protective factors for preventing secondary conditions, and to assess the cost- and prevention-effectiveness of interventions targeted to the needs of persons with disabilities.
The purpose of the Part 2 cooperative agreement award is to design, conduct, and report the findings of a model project to prevent pressure sores and other selected secondary conditions among persons with spinal cord injury. This project should explore the feasibility of a home-based intervention; e.g., a public health nurse visitation program addressing medical, social, and environmental factors associated with the development of pressure sores and other selected secondary conditions.
Projects receiving funds for either Part 1 or Part 2 are expected to design, document, and publish the results of their research in a manner that promotes generalizability so that academic institutions, State and local agencies, disabilities service programs, and other organizations concerned with public health and health promotion programs for persons with disabilities and rehabilitation can benefit. Project activities must provide evidence that all project programs will involve and be accessible to persons with disabilities.
Background--General
The CDC Office on Disability and Health (proposed, current name-Disabilities Prevention Program) has provided grant funds to universities, rehabilitation hospitals, and State agencies since 1988 to increase understanding of the disabling process and conduct research to prevent secondary conditions. Those research grants have focused on the frequency, severity, cost, and significance of a specific, or a range of secondary conditions associated with a prescribed primary disability (e.g., spinal cord injury, traumatic brain injury, fetal alcohol syndrome, cerebral palsy, and the late effects of polio).
Background for Part 1
Part 1 of the research emanating from this Announcement is designed to examine, understand, and document the participation of persons with disabilities within their social environment as related to a particular disability domain. Disability domains are categories of activities that individuals perform in everyday life. Applicants should propose grant activities in at least one of the following disability domains: (1) Mobility (locomotion); (2) personal care/home management; (3) communication; and (4) learning. Descriptions and examples within these disability domains are as follows:
1. Mobility (locomotion) refers to an individual's ability to perform distinctive activities associated with moving; both himself and objects, from place to place. Examples of underlying conditions or diagnoses include spinal cord injury, cerebral palsy, arthritis, lower limb loss, blindness, or stroke. Secondary conditions may include urinary tract infections, cardiovascular deficit due to sedentary lifestyle, pressure sores, results from falls, bowel obstruction, dependence on assistive devices and its economic impact, lack of access to medical care, and social isolation.
2. Personal Care/Home Management refers to an individual's ability to perform basic self-care activities such as feeding, bladder and bowel care, personal hygiene, dressing, financial management, and homemaking. Examples of underlying conditions or diagnoses include asthma, arthritis, stroke, osteoporosis, paraplegia, or multiple sclerosis. Secondary conditions may include lack of physical fitness, incontinence, weight gain, poor nutrition, and emotional dependence.
3. Communication refers to an individual's ability to generate and express messages, and to receive and understand messages. Examples of underlying conditions or diagnoses include cerebral palsy, deafness, aphasia from varied pathology, or congenital speech impediments. Secondary conditions may include family dysfunction, isolation, and constraints and barriers in employment opportunity.
4. Learning refers to an individual's ability to profit from daily experiences, and includes aspects of receiving, processing, remembering, and using information. Examples of underlying conditions or diagnoses include mental retardation, spina bifida, fetal alcohol syndrome, or traumatic brain injury. Secondary conditions may include depression, behavioral problems, increased family stress, and poor academic and vocational performance.
Note that the examples listed above are illustrative, and not intended to be exhaustive; several secondary conditions may apply to more than one disability domain. Because of limited funds and other resources available, this Announcement does not include disabilities created by psychiatric diagnoses, although mental health issues may be appropriately included as secondary conditions.
The model of health promotion used for Part 1 of this Announcement assumes a goal of promoting health and preventing secondary conditions among persons with disabilities. The basic conceptual model is represented by the International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Revisions proposed to the ICIDH framework include definitions and concepts consistent with a broader perspective of the disabling process. Of particular importance is the utility of this paradigm for data collection, given its classification of disabilities and related variables. Definitions referenced in this framework are presented below:
1. Participation refers to the product of the interactions between the individual and the environment, and is delineated by the outcomes of that interaction. The intent of this dimension is to document the nature and extent of a person's involvement in life activities. This dimension is broadly analogous to the term "Handicap" in the ICIDH (World Health Organization, 1980) model and the term "Disability" in the Institute of Medicine (IOM, 1991) model.
2. Environment refers to the physical, social, and cultural contexts in which the individual acts. Elements of the environment create the backdrop for the individual's participation, as facilitators or hindrances.
3. Impairment refers to loss or abnormality in a body structure, organ, or system as a consequence of disease, injury, or congenital disorder. In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function.
4. Disability refers to any restriction or lack of ability to carry out simple or complex activities of everyday life. It is the manifestation of an underlying impairment, but may vary by age or developmental stage.
5. Health Promotion is the effort to educate persons with a disability about the relationship between protective and risk factors and secondary conditions, and to increase behaviors consistent with a healthy lifestyle. Health promotion concerns those behaviors that affect health status and are under the direct control of persons who have a disability.
6. Secondary Conditions are those physical, medical, cognitive, emotional, or psychosocial conditions, (to which persons with a disability are more vulnerable by virtue of an underlying condition), including adverse outcomes in health, wellness, participation, and quality of life.
7. Protective Factors are biological, environmental (social and physical), and lifestyle or behavioral characteristics that reduce or mitigate the risk for adverse health outcomes, enhance coping skills, induce a positive mediating influence against the effects of secondary conditions, and/or promote health.
8. Risk Factors are biological, environmental (social and physical), and lifestyle or behavioral characteristics that increase the risk for adverse health outcomes. Identifying such factors can contribute to determining a course of action during the disabling process, including the development of preventive interventions.
9. Quality of Life is associated with the concept of well-being, encompassing both physical and psychosocial determinants. Components of quality of life include performance of social roles, physical status, emotional status, social interactions, economic status, and self-perceived or subjective health status.
Background for Part 2
Pressure sores are the most common and costly complication among persons with spinal cord injury. There are an estimated 200,000 persons with spinal cord injury in the United States. Almost all persons with spinal cord injury will experience at least one pressure sore in their lifetime. Although estimates vary, the prevalence of pressure sores may be more than 20 percent among persons with spinal cord injury. One study showed that the average institutional costs (for acute care and rehabilitation hospitalizations) for pressure sores were $92,723. The overall cost of hospital stays and economic loss due to pressure sores may be over $6 billion each year (regardless of underlying condition).
Pressure sores are lesions caused by unrelieved pressure, trauma, friction, and/or moisture which damages the skin and then the underlying tissues. Much is known about the factors associated with pressure sore development and treating pressure sores once they occur. Pressure sores are also considered the secondary condition most amenable to prevention among persons with spinal cord injury. As part of rehabilitation, persons with spinal cord injury are taught how to care for their skin and how to prevent pressure sores once they leave the hospital environment and return home. Despite this training, persons with spinal cord injury continue to experience pressure sores.
Despite what is known about the factors associated with the development of pressure sores, little is known about why persons with spinal cord injury do not optimize skin care and other behaviors to prevent pressure sores from occurring. One study, conducted by the Arkansas State Spinal Cord Commission, found initial success with an in-home education program in which the incidence of pressure sores decreased by 19 percent. In long-term follow-up, however, the incidence of pressure sores actually increased among program participants.
Because few such programs have been developed and implemented, little is known about community-based prevention programs for the prevention of pressure sores. The emphasis here is prevention and early intervention rather than treatment. Recognizing that individual situations vary, assessment of risk for developing pressure sores and education for prevention should be done in the context of individual needs, strengths, and environment. Applicants should use available information on pressure sore prevention in the post-rehabilitation, community setting to develop a model program and plan, and implement and evaluate the feasibility of doing a home-visitation program.
Program Requirements for Part 1
Applicants must design, develop, and evaluate health promotion programs or conduct an epidemiologic study that will contribute to a national information base for the prevention of secondary conditions. CDC has indicated the following four areas for emphasis under Part 1 of this Announcement and applicants must develop their proposals to respond to one of these four areas.
1. Development of reliable and valid measurements to assess Participation among persons with disabilities, and characteristics of the Environment which influence that participation. Applicants may choose to work across disability domains. These are evolving dimensions to the ICIDH framework to replace the "Handicap" dimension. There is a pressing need to clarify and understand these dimensions and characteristics. There is a benefit in having the capacity to assess empirically the influence of environment on participation in life activities for persons with disabilities. The need to assess these dimensions to improve the health status, expand research emphasis, and develop policy regarding persons with disabilities is both timely and critical.
2. Work toward measuring the cost-effectiveness of one or more intervention strategy(ies) designed to minimize the effects of or prevent selected secondary condition(s). In order to guide the conduct of cost-utility and cost-effectiveness analysis in federally funded programs, the PHS recently developed consensus-based Cost-Effectiveness Recommendations which have direct applicability to research on the prevalence and consequences of secondary conditions. Applying cost-utility and/or cost-effectiveness analytic techniques improves the basis for the allocation of health care resources across a broad range of secondary conditions among many preventive, therapeutic, rehabilitative, and public health interventions. The PHS Cost-Effectiveness Recommendations emphasize standardization of methods, adoption of the societal perspective in conducting analyses, and use of the summary measure known as the "quality-adjusted life year" (QALY) as a comparable metric for recording the effects of different interventions. Thus, there is both an opportunity and a need to establish basic prevention strategies that focus on common secondary conditions, and to apply methods that evaluate their comparative cost-effectiveness, so that successful strategies and approaches can be generalized and replicated in other settings. Reference citations for these published recommendations are presented in the Bibliography, which is an attachment to this Announcement.
3. Identification and measurement of protective factors and risk factors within a disability domain, and measurement of the effectiveness of preventive interventions that focus on an identified age group that includes: (a) Children; (b) youth; and/or (c) older adults. Given the paucity of research on secondary conditions generally, there is even less data available on specific age groups within the population which may be even more susceptible to developing secondary conditions.
4. Identification and measurement of protective factors and risk factors within a disability domain, and measurement of the effectiveness of preventive interventions among specified populations that include women and/or ethnic minority groups, or a combination of the two. Among persons with disabilities, susceptibility to secondary conditions may be higher in particular populations. Emphasis should be given to populations considered to be at greatest risk.
Program Requirements for Part 2
Applicants must develop proposals to address pressure sores and other selected secondary conditions among persons with spinal cord injury. The model program proposed should be home-based and able to collect information on and address medical, social, and environmental factors associated with the development and progression of pressure sores and other selected secondary conditions.
Applicants should address the development, implementation, and appropriate evaluation of a home-based model project to prevent pressure sores and other selected secondary conditions among persons with spinal cord injury. The emphasis of the project should be to assess the feasibility of the program, including access to persons with spinal cord injury, recruiting and retaining study participants, logistical management and support of a home-based visitation program, and educational materials for the prevention of pressure sores and other selected secondary conditions. Applicants should consider addressing persons with spinal cord injury at greatest risk of secondary conditions, including persons of low socioeconomic status or persons considered medically underserved. A close working relationship between the recipient and CDC is expected.
Applicants for Part 2 should develop a prevention program based on a public health nurse, home-visit model. The project should include the following elements:
1. Collect, compile, and analyze information relevant to the prevention of pressure sores and other selected secondary conditions among persons with spinal cord injury;
2. Develop a program consisting of the following phases:
a. A twelve month planning/recruitment phase where the recipient explores existing materials relevant to the program, identifies and selects other secondary conditions to be addressed, identifies educational materials to be used for the prevention of pressure sores and the other identified secondary conditions, hires and trains home visitation staff, and identifies and recruits study participants.
b. An implementation phase where the home visitation project is implemented (data collection, education) in the target population.
c. A monitoring phase where the intervention project continues with the monitoring of the intervention, the occurrence of pressure sores, the occurrence of other secondary conditions, and associated risk factors.
d. A follow-up phase for continued monitoring and evaluation.
3. Develop and implement the methods (both scientific and operational) for collecting data to assess the impact of the intervention.
4. Determine how data will be maintained including format and databases, and confidentiality protections.
5. Obtain the necessary clearances and agreements to proceed with all aspects of the proposed project, including appropriate human subjects clearances and agreements with other organizations and individuals needed to complete the project. This specifically includes working with CDC to obtain human subjects clearances and approval for data collection activities.
6. Identify or develop, and pilot test data collection instruments.
7. Establish baseline rates for pressure sores or other secondary conditions within the target group. Identify potential data sources to provide baseline information or data for comparison.
8. Monitor progress toward achievement of project goals through the use of realistic, measurable, time-oriented objectives for all phases of the project.
9. Develop collaborative relationships with voluntary, community-based public and private organizations addressing issues important to persons with spinal cord injury. These could include centers for independent living, and local chapters of the Paralyzed Veterans of America and the National Spinal Cord Injury Association.
Cooperative Agreement Activities (Part 2 Only)
In conducting activities to achieve the purposes of Part 2 of this Announcement, the recipient shall be responsible for activities listed under A. (Recipient Activities), and CDC shall be responsible for activities listed under B. (CDC Activities):
A. Recipient Activities:
1. Collect, compile, and analyze information relevant to the prevention of pressure sores and other selected secondary conditions among persons with spinal cord injury.
2. Develop a home-visit prevention model program consistent with the public health nurse approach and framework.
3. Implement the home visitation project (data collection, education) in the target population.
4. Monitor the intervention, the occurrence of pressure sores, the occurrence of other secondary conditions, and associated risk factors.
5. Provide for ongoing project evaluation.
6. Provide for final dissemination of the products of the research including conclusions and recommendations suitable for broad replication in other prevention settings.
B. CDC Activities:
1. Provide technical consultation on: existing materials relevant to the program (educational materials to be used for the prevention of pressure sores and the other identified secondary conditions), the selection of other secondary conditions to be targeted, and the identification and recruitment of study participants.
2. Participate in program planning and development.
3. Participate in the development of the evaluation aspects of the project.
4. Provide consultation in the development of data collection instruments, methods, and procedures.
Application Contents--Part 1
1. Describe the applicant organization's current activities that relate to the prevention of secondary conditions. Define the populations included and the scope of any current research, specific health promotion or training interventions, and the outcomes and use made of such interventions and services.
2. Provide the rationale and basis for both the selection of a disability domain(s) and the selected area for emphasis for the proposed research agenda.
3. Discuss how the applicant organization is in an advantageous position to conduct the proposed project, and describe the special competencies residing in the applicant organization for conducting the project.
4. Describe the applicant's experience and prior performance in similar programs that would be beneficial in carrying out the proposed project and outline the function and identity of all collaborating organizations in the proposed project.
5. Describe the existing or proposed linkages and formal collaborations to meet all operational and epidemiologic requirements for achieving the goals and objectives of the research agenda, including timely access to needed data and study populations and clients related to the selected area for emphasis.
6. Present letters and agreements that demonstrate commitment and support and provide tangible evidence of appropriate collaboration.
7. Describe the data to be collected, accessed, or developed to conduct the proposed project, and the methods for collecting data from specified sources. Discuss the strengths and weaknesses of each data source relative to the proposed project. Explain how the standardization and uniformity of data will be addressed to make the information useful to other organizations.
8. Present the design of the study proposal or intervention that includes: (a) Providing case definitions; (b) outlining methods of enrolling and managing cases, clients, or cohorts; (c) describing plans to ascertain cases and estimate sample size or study power; (d) describing study methods and an analytical plan; (e) describing how the confidentiality of cases identified through the project will be protected; and (f) how the research will be evaluated.
9. Present the plan for dissemination of findings and recommendations. Indicate the prospects for replicating the research in the development of interventions that will benefit other populations, including applications for national use.
10. Describe the placement of the project within the applicant organization and outline how it will function to meet the objectives of the grant. Provide an organizational chart illustrating the placement of the project and how it will interact with partner entities.
11. Present the management plan, incorporating methods and time frames for conducting the project including staff selection and appointment, intra/inter-agency agreements, data access negotiations, management oversight, and development of training or health promotion material. Provide curriculum vitae for identified key personnel.
12. Present overall goals and objectives for the entire three year project period, including detailed and specific goals and quarterly objectives with timelines, in a work plan that covers the first two budget years.
13. Present the methods, approach, and designation of responsibilities for evaluation of the management elements of the project over the duration of the grant.
14. Present what will occur to assure that all project activities and facilities will permit full access to minorities, both sexes, and persons with disabilities, and to provide opportunities for persons with disabilities to participate in research operations.
15. Prepare specific budget and cost projections with full narrative justification, for all listed budget class categories, identifying both Federal and non-Federal sources. Indicate the amount and categories of applicant cost-sharing in the total budget. Provide projections and commitments (citing sources of funding) for cost-sharing in both the second and third years of the project period.
16. Human Subjects: This section must describe the degree to which human subjects may be at risk and the assurance that the project will be subject to initial and continuing review by the appropriate institutional review committees.
Evaluation Criteria--Part 1 (Total 100 Points)
Under Part 1, applications for Secondary Conditions Research will be reviewed and evaluated for technical merit based on the following factors:
1. Evidence of Understanding: (15 Points)
Evaluation will be based on:
a. The applicant's description of the public health significance of secondary conditions and adherence to the purposes of this Announcement, with an emphasis on the applicant's capacity to reach the populations proposed.
b. The organizational rationale for determining the disability domain(s) for project operations, and for addressing one of the areas for emphasis outlined in the Program Requirements section for Part 1.
2. Research Resources and Organizational Capacity: (20 Points)
Evaluation will be based on:
a. The capability of the applicant to conduct the project, taking into account its institutional experience and current activities in the field proposed for this research.
b. The ability of the applicant to ensure timely access to necessary population-based data related to the selected area for emphasis.
c. The capacity of the applicant to identify and work with selected targeted activities and expeditiously gather required information about the clients or populations under investigation.
d. The applicant's capacity to provide evidence of effective collaborations and research linkages enabling the applicant to meet all protocol development and operational research requirements for the project.
3. Research Approach: (35 Points)
Evaluation will be based on:
a. The extent to which the proposed methods, sources of data, process for identifying individuals and cohorts with disabilities, and/ or conducting health promotion programs will be employed and function to address the selected area for emphasis in this Announcement.
b. The overall strength of the research design including: (1) The rationale and appropriateness of the study protocol and methods; (2) the quality and scope of the data collection and data analysis plan; (3) the power of the scientific dimensions in the design, including sample size, measurements, etc; (4) the scope of the plan to assure confidentiality as applicable to the protocol; and (5) the process by which the research will be evaluated, including expected outcomes. For applicants selecting the second area for emphasis pertaining to cost-effectiveness, evaluation of the proposed methods will also be based on adherence to generally accepted techniques for conducting and reporting on cost-utility or cost-effectiveness analyses.
c. The overall information dissemination plan for presenting and publishing the findings and recommendations of the research, and the potential for generalizability and replicability of the study.
4. Management Plan and Project Goals and Objectives: (30 Points)
Evaluation will be based on:
a. The description of the management plan and approach, including the project's location within the applicant organization, and the described process by which the applicant will meet the goals and objectives of the proposed research agenda.
b. The presentation of the specified tasks and responsibilities for all positions proposed for financial assistance, and for other personnel contributing to the requirements of the project.
c. The applicability of the proposed goals and specific objectives related to the conduct of the project, including proposed timelines.
d. The process for overall evaluation of the management of the project, including the assignment of responsibility for ongoing review of specified components.
e. The extent to which the application furnishes evidence that project activities will be fully accessible to minorities, both sexes, and persons with disabilities, and will include opportunities for persons with disabilities to participate in project activities.
5. Project Budget: (Not Scored)
This criteria includes the adequacy of the project application budget in relation to program operations, collaborations, and services; the extent of cost-sharing; and the extent to which the budget is reasonable, clearly justified, accurate, and consistent with the purpose of this Announcement.
6. Human Subjects: (Not Scored)
The extent to which the applicant complies with the Department of Health and Human Services Regulations (45 CFR Part 46) regarding the protection of human subjects.
Application Contents--Part 2
1. Describe the impact of pressure sores and other proposed secondary conditions.
2. Describe the applicant organization's current activities related to the prevention of pressure sores and other secondary conditions among persons with spinal cord injuries. Define the populations included.
3. Describe the target population, the rationale for selection of that population, and whether and why the population is considered undeserved.
4. Discuss how the applicant organization is in an advantageous position to conduct the proposed project, and describe the special competencies residing in the applicant organization for conducting the project.
5. Describe the applicant's prior experience and performance in similar programs that would be beneficial in carrying out the proposed project and outline the function and identity of all collaborating organizations in the proposed project.
6. Describe the existing and proposed linkages and formal collaborations to meet all operational and epidemiologic requirements for achieving the goals and objectives of the project. Letters and agreements that demonstrate commitment and support and provide tangible evidence of collaboration for specific aspects of the proposed research must be included.
7. Present the design of the study proposal or intervention that includes: (a) Providing case definitions; (b) outlining methods of enrolling and managing cases, clients, or cohorts; (c) describing plans to ascertain cases; (d) describing study methods and an analytical plan; (e) describing how the confidentiality of cases identified through the project will be protected; and (f) how the research will be evaluated.
8. Describe the data to be collected, accessed, or developed to conduct the proposed project, and the methods for collecting data from specified sources. Discuss the strengths and weaknesses of each data source to the proposed project.
9. Present the plan for dissemination of findings and recommendations. Indicate the prospects for replicating the research in the development of interventions that will benefit other populations, including applications for national use.
10. Describe the placement of the project within the applicant organization and outline how it will function to meet the objectives of the cooperative agreement. Provide an organizational chart illustrating the placement of the project and how it will interact with partner entities.
11. Describe the management plan, incorporating methods and time frames for conducting the project in operational areas including staff selection and appointment, protocol development, intra/inter-agency agreements, data access negotiations, study population monitoring and tracking systems, data analysis, and development of training or health promotion material. Provide curriculum vitae for identified key personnel.
12. Present overall goals and objectives for the entire three year project period, including detailed and specific goals and quarterly objectives with timelines, in a work plan that covers the first two budget years.
13. Present the plan, methods, approach, and designation of responsibilities for evaluation of the management elements of the project over the duration of the project.
14. Present what will occur to assure that all project activities and facilities will permit full access to persons with disabilities, and to provide opportunities for persons with disabilities to participate in research operations.
15. Prepare specific budget and cost projections with full narrative justification, for all listed budget class categories, identifying both Federal and non-Federal sources. Indicate the amount and categories of applicant cost-sharing in the total budget. Provide projections and commitments (citing sources of funding) for cost-sharing in both the second and third years of the project period.
16. Human Subjects: This section must describe the degree to which human subjects may be at risk and the assurance that the project will be subject to initial and continuing review by the appropriate institutional review committees.
Evaluation Criteria--Part 2 (Total 100 Points)
Under Part 2, applications for the Prevention of Pressure Sores and other Secondary Conditions among Persons with Spinal Cord Injury will be reviewed and evaluated for technical merit based on the following factors:
1. Evidence of Understanding: (15 Points)
Evaluation will be based on:
a. The applicant's description of the public health significance of pressure sores and other secondary conditions (as chosen by the applicant).
b. The rationale for determining the target population of persons with spinal cord injury.
2. Research Resources and Organizational Capacity: (20 Points)
Evaluation will be based on evidence of:
a. The capability of the applicant to conduct the project, taking into account prior history of conducting research and disseminating results in peer-reviewed publications and in presentations.
b. The ability of the applicant to ensure timely access to the population, including prior history of working with the target population.
c. The capacity of the applicant to identify and work with its selected targeted activities and expeditiously gather required information from the program participants and other populations related to the program activities.
d. The applicant's capacity to provide evidence of effective collaborations and research linkages (i.e., letters of commitment) enabling the applicant to meet all protocol development and operational research requirements for the project.
3. Research Approach: (35 Points)
Evaluation will be based on:
a. The extent to which the proposed methods, sources of data, process for identifying individuals and cohorts with spinal cord injuries will be employed to address the Program Requirements section for Part 2.
b. The overall strength of the research design including: (1) The rationale and appropriateness of the study protocol; (2) the quality of the data collection plan; (3) the scope of the plan to assure confidentiality as applicable to the protocol; and (4) the process by which the research will be appropriately evaluated, including expected outcomes.
c. The overall information dissemination plan for presenting and publishing the findings and recommendations of the research, and the potential for generalizability and replicability of the study.
4. Management Plan and Project Goals and Objectives: (30 Points)
Evaluation will be based on:
a. The description of the management plan and approach.
b. The presentation of the specified tasks and responsibilities for all positions proposed for financial assistance, and for other personnel contributing to the requirements of the project.
c. The applicability of the proposed goals and specific objectives related to the conduct of the project, including proposed timelines.
d. The proposed process for overall evaluation of the management of the project, including the assignment of responsibility for ongoing review of specified components.
e. The extent to which the application furnishes evidence that project activities will be fully accessible to persons with disabilities, and will include opportunities for persons with disabilities to participate in project activities.
5. Project Budget: (Not Scored)
This criteria includes the adequacy of the project budget in relation to program operations, collaborations, and services; the extent of cost-sharing; and the extent to which the budget is reasonable, clearly justified, accurate, and consistent with the purpose of this Announcement.
6. Human Subjects: (Not Scored)
The extent to which the applicant complies with the Department of Health and Human Services Regulations (45 CFR Part 46) regarding the protection of human subjects.
Reporting Requirements
Narrative progress reports will be required twice annually; and will be due 30 days after the close of each six-month period based on the starting date of the project. An original and four copies of the narrative progress report should be submitted to the CDC Grants Management Branch at dates to be specified in the Notice of Grant Award. An original and two copies of the Financial Status Report is required no later than 90 days after the end of each budget period.
Funding Priorities
Under Part 1, four areas are listed for emphasis within the Program Requirements section. To the extent that there are a sufficient number of high-ranking applications, CDC plans to make awards in all four areas of emphasis. Part 1 applications will be reviewed by an internal CDC review panel.
Under Part 2, CDC plans to fund one project to address pressure sore prevention among persons with spinal cord injury. Part 2 applications will be reviewed by a Special Emphasis Panel (SEP) with knowledge and expertise in pressure sores and/or epidemiology and public health. The SEP may consist of a physiatrist, a physical therapist, an epidemiologist, a program management official, and a person with a disability or family member of a person with a disability.
Special Instructions
Applicants must submit a separate, typed abstract or summary of their proposal consisting of no more than two double-spaced pages as a cover to their application. Applicants should include a table of contents for both the project narrative and attachments. Applicants must denote the component of this Announcement (Part 1 or Part 2) for which they are submitting a proposal. The budget narrative and full budget justification must be placed immediately after the table of contents and abstract for the main application. Applicants should follow the application contents section for the selected component of this Announcement, as those elements are arranged to be compatible with the respective evaluation criteria.
The main body of the application narrative should not exceed 50 double-spaced pages. Pages must be numbered and printed on only one side of the page. All material must be typewritten; with 10 characters per inch type (12 point) on 8-\1/2\" by 11" white paper with at least 1 margins, headers and footers (except for applicant-produced forms such as organizational charts, graphs and tables, etc.). Applications must be held together only by rubber bands or metal clips, and not bound together in any other way.
Attachments to the application should be held to a minimum in keeping to those items required by this Announcement. Other columns on the Standard Form 424A budget sheet should be used to define and certify other cost-sharing, with the specific sources identified and documented in the budget narrative.
CDC expects to sponsor annual project workshops for all grantees. By virtue of accepting an award, projects have agreed to use grant or cooperative agreement funds to travel to and participate in these workshops. Applicants should budget travel funds to attend a workshop in Atlanta during the first year.
Executive Order 12372
Applications are not subject to the Intergovernmental Review of Federal Programs as governed by Executive Order 12372.
Public Health System Reporting Requirements
This program is not subject to the Public Health System Reporting Requirements.
Catalog of Federal Domestic Assistance (CFDA)
The Catalog of Federal Domestic Assistance number is 93.184.
Other Requirements
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. Applicants will be responsible for providing assurance in accordance with the appropriate guidelines and forms provided in the application kit.
In addition to other applicable committees, Indian Health Service (IHS) institutional review committees also must review the project if any component of IHS will be involved or will support the research. If any American Indian community is involved, its tribal government must also approve that portion of the project applicable to it.
Paperwork Reduction Act
Projects that involve the collection of information from 10 or more individuals, and funded by grants/cooperative agreements will be subject to review by the Office of Management and Budget (OMB) under the Paperwork Reduction Act.
Animal Subjects
If the proposed project involves research on animal subjects, the applicant must comply with the "PHS Policy on Humane Care and Use of Laboratory Animals by Awardee Institutions." An applicant organization proposing to use vertebrate animals in PHS-supported activities must file an Animal Welfare Assurance with the Office of Protection from Research Risks at the National Institutes of Health.
Women and Minority Inclusion Policy
It is the policy of CDC to ensure that women and racial and ethnic groups will be included in CDC-supported research projects involving human subjects, whenever feasible and appropriate. Racial and ethnic groups are those defined in OMB Directive Number 15 and include American Indian, Alaska 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. In conducting the review of applications for scientific merit, review groups will evaluate proposed plans for inclusion of minorities and both sexes as part of the scientific assessment and assigned score. 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, Friday, September 15, 1995, pages 47947-47951.
Application Submission and Deadline
A. Pre-Application Letter of Intent
Although not a prerequisite of application, a non-binding letter of intent to apply is requested from potential applicants. The letter should be submitted to the Grants Management Officer whose name is noted in section B below. The letter should be postmarked no later than 30 days prior to the submission deadline. The letter of intent should identify the Announcement Number; name the proposed project director; and in a paragraph, describe the scope of the proposed project. The letter will not influence review or funding decisions, but it will enable CDC to plan the review more efficiently and ensure that each applicant receives timely and relevant information prior to application submission.
B. Application Submission
Applicants should submit an original and four copies of the application (PHS Form 398--OMB Number 0925-0001 revised 5/95), and adhere to the ERRATA Instruction Sheet contained in the Grant Application Kit. Applications must be submitted to Mr. Ron Van Duyne, Grants Management Officer, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), 255 East Paces Ferry Road, NE., Room 300, Mailstop E-13, Atlanta, Georgia 30305, on or before Thursday, May 15, 1997.
1. Deadline: Applications will 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 will not be acceptable as proof of timely mailing.)
2. Late Applications: Applications that do not meet the criteria in 1.a. or 1.b. above are considered late. 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 your name, address, and telephone number and will need to refer to Announcement Number 731. You will receive a complete program description, information on application procedures, and application forms. In addition, this Announcement and the bibliography attachment for Part 1 is also available through the CDC Home Page on the Internet. The address for the CDC Home Page is http://www.cdc.gov. If you have questions after reviewing the contents of all the documents, business management technical assistance may be obtained from Georgia L. Jang, Grants Management Specialist, Grants Management Branch, Procurement and Grants Office, Centers for Disease Control and Prevention (CDC), East Paces Ferry Road, NE., Room 321, Mailstop E-13, Atlanta, Georgia 30305, telephone number (404) 842-6814. (Internet address: glj2@cdc.gov).
For Part 1 applications, program assistance may be obtained from Joseph B. Smith, Office on Disability and Health, National Center for Environmental Health, CDC, 4770 Buford Highway, Building 101, Mailstop F-29, Atlanta, Georgia 30341, telephone (770) 488-7082. (Internet address: jos4@cdc.gov). Epidemiologic and research-related technical assistance is available from Donald J. Lollar, Ed.D. at the same address, telephone (770) 488-7094. (Internet address: dcl5@cdc.gov).
For Part 2 applications, program assistance may be obtained from Douglas R. Browne, National Center for Injury Prevention and Control, CDC, 4770 Buford Highway, Building 101, Mailstop F-41, Atlanta, Georgia 30341, telephone (770) 488-4031. Internet address: drb7@cdc.gov. Epidemiologic and research-related technical assistance is available from Joe Sniezek, M.D., M.P.H. at the same address and telephone number. Internet address: jes6@cdc.gov. A packet of background information for Part 2 is available by contacting the above listed CDC staff.
Potential applicants may obtain a copy of "Healthy People 2000" (Full Report; Stock number 017-001-00474-0) or "Healthy People 2000" (Summary Report; Stock number 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325, telephone (202) 512-1800.
Dated: March 7, 1997. Joseph R. Carter, Acting Associate Director for Management and Operations, Centers for Disease Control and Prevention (CDC).
[FR Doc. 97-6489 Filed 3-13-97; 8:45 am] BILLING CODE 4163-18-P
CONFERENCE REPORT ON H.R. 4577, DEPARTMENTS OF LABOR, HEALTH AND HUMAN
SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATIONS ACT, 2001
Friday, December 15, 2000
Mr. YOUNG of Florida submitted the following conference report and
statement on the bill (H.R. 4577) making appropriations for the
Departments of Labor, Health and Human Services, and Education, and
Related Agencies for the fiscal year ending September 30, 2001, and for
other purposes:
Conference Report (H. Rept. 106-1033)
Centers for Disease Control and Prevention
Disease Control, Research, and Training
The conference agreement includes $3,868,027,000 for
disease control, research, and training instead of
$3,386,369,000 as proposed by the House and $3,251,996,000 as
proposed by the Senate.
The conference agreement includes $175,000,000 for
equipment, construction, and renovation of facilities as
proposed by the Senate instead of $145,000,000 as proposed by
the House. The conference agreement includes bill language to
allow CDC to enter into a single contract or related
contracts for the full scope of development and construction
of facilities as proposed by the Senate. The House bill
provided this authority only for laboratory building 18.
The conference agreement includes a total of $97,354,000
for the National Center for Health Statistics instead of
$86,759,000 as proposed by the House and $105,110,000 as
proposed by the Senate. The conference agreement also
includes bill language designating $71,690,000 of the total
to be available to the Center under the Public Health Service
Act one percent evaluation set-aside as proposed by the House
instead of $91,129,000 as proposed by the Senate.
The conference agreement includes bill language to allow
funds recouped from fiscal years 2000 and 2001 obligations
for the influenza vaccine stockpile to be used in fiscal year
2001 for childhood vaccine purchase.
The conference agreement does not include language proposed
by the Senate to allow funds made available for section 317A
of the Public Health Service Act to be used at Early Head
Start program sites. The House bill contained no similar
provision.
The conference agreement consolidates the salaries and
expenses of CDC into a single account. Salaries and expenses
activities encompass all non-extramural activities with the
exception of program support services, centrally managed
services, and buildings and facilities. The agency may
allocate administrative funds for extramural program
activities according to its judgment. Funds should be
apportioned and allocated consistent with the table, and any
changes in funding are subject to the normal notification
procedures.
The conference agreement includes $175,969,000 for the
prevention health services block grant instead of
$175,964,000 as proposed by the House and $175,124,000 as
proposed by the Senate. Within the total provided,
$44,225,000 is for rape prevention and education activities
previously funded through the Crime Trust Fund.
The conference agreement includes $23,012,000 for
prevention centers instead of $23,000,000 as proposed by the
House and $14,080,000 as proposed by the Senate.
The conferees include $700,000 for the Roger Williams
Medical Center Healthlink program in Providence, Rhode Island
to develop and implement a comprehensive health promotion
initiative for senior retirees.
The conference agreement includes $529,461,000 for
childhood immunization instead of $472,966,000 as proposed by
the House and $499,005,000 as proposed by the Senate.
Included in this amount is an increase of $42,487,000 for
operation/infrastructure activities, $5,000,000 for global
polio eradication activities, and $20,000,000 for vaccine
purchase. The conferees intend that funds available for
vaccine purchase are for all currently licensed and
recommended vaccines. In addition, the Vaccines for Children
(VFC) program funded through the Medicaid program is expected
to provide $469,054,000 in vaccine purchases and distribution
support in fiscal year 2001, for a total program level of
$1,016,528,000.
The conferees recommend that CDC discontinue immunization
incentive grants and that CDC award the $33,000,000
previously committed for this program as part of the entire
operations funding to support State grantees cumulative core
budgets. Incorporating incentive grants into States' base
operations award would allow more States to receive a greater
proportion of their core budget and help improve their
overall immunization coverage levels. The conferees recommend
that CDC use grant funding made available due to the
completion of Congressionally-directed demonstration projects
to ensure that all States receive at least the same level of
operational funding received in fiscal year 2000, thereby
holding them harmless during this funding shift from a
formula based approach.
Funding for measles vaccine for supplemental measles
immunization campaigns and epidemiological, laboratory, and
programmatic/operational support to the World Health
Organziation and its member countries is included in measles
eradication funding not polio eradication funding as
identified in the Senate report.
The conference agreement includes $767,246,000 for HIV/AIDS
instead of $673,367,000 as proposed by the House and
$640,000,000 as proposed by the Senate. Included in this
amount is an additional $3,000,000 to maintain the current
hematologic and blood safety program commitments and to expand
support for the treatment centers network in carrying out
initiatives to address the complications of hemophilia, including
HIV/AIDS, blood safety surveillance and monitoring, and the needs
of women with bleeding disorders.
The conferees recognize the devastating impact of the
global AIDS epidemic upon individuals, families and
communities in Africa and Asia and have included $104,527,000
for global HIV/AIDS activities at CDC, which shall be
available until September 30, 2002. This amount is an
increase of $69,527,000 over the fiscal year 2000
appropriation. With funding received in fiscal year 2000,
CDC, in collaboration with USAID and other federal agencies,
has begun to combat the AIDS epidemic in 14 of the hardest
hit countries in Africa and in India. The conferees urge CDC
to continue to work in collaboration with USAID and other
departments such as the Department of Defense and the
Department of Labor, and other DHHS agencies especially HRSA,
as well as international agencies, non-governmental
organizations and country governments to halt the spread of
the epidemic and lessen its impact. In those countries where
CDC already has a presence, CDC, in collaboration with USAID
and HRSA, should assist in implementing country-wide care and
prevention programs. This will include partnering with HRSA
to develop health care services focused on mobilizing
communities for the development of palliative care, basic
treatment, and support services. In addition, CDC should
begin to assist other areas at high risk for severe epidemics
including other African countries, Southeast Asia, and the
Caribbean/Latin American region. Finally, CDC should support
targeted anti-retroviral treatment demonstration projects in
countries where sufficient care and treatment infrastructures
exist. Within the total for international HIV/AIDS
activities, the conferees provide $3,000,000 through CDC to
support HRSA activities aimed at improving professional
education and training relating to this initiative. The
conferees have also included language to extend certain
authorities of the Department of State to the Secretary of
HHS so that CDC may use State's administrative systems for
personnel, contracting and procurement, and for limited
renovation or construction of essential program facilities.
As a preventive vaccine offers the world's best hope for
turning the tide against the global AIDS pandemic, and since
international collaborations are essential for this goal, the
conferees encourage CDC to work collaboratively with the
International AIDS Vaccine Initiative and other global
organizations to accelerate the development and testing of
promising vaccine candidates.
The conferees have provided additional funds to respond to
the unmet needs identified through the community planning
process. These funds are to augment the cooperative
agreements between CDC and State and local health
departments.
The conferees recommend that CDC allocate an increase to
evaluate HIV prevention service delivery programs to improve
funding decision-making and to implement more rapid effective
transfer of technology to community based service delivery
organizations and health departments. Approximately half of
this amount should support evaluation activities to track
service delivery by community based organizations, and
utilize cost-effectiveness analysis in HIV prevention. The
remaining funds would be used to expand technology transfer
regarding HIV prevention through activities such as regional
technical assistance, technology transfer, and training for
the purpose of providing links between evidence-based HIV
prevention science and public health departments, community
planning groups, healthcare providers, and prevention science
providers.
The conference agreement includes $88,000,000 to fund CDC
activities that are designed to address the trend of the HIV/
AIDS epidemic in communities of color, based on the most
recent estimated living AIDS cases, HIV infections and AIDS
mortality among ethnic and racial minorities as reported by
the CDC. The program initiative includes funds for the ''Know
Your Status'' campaign. The conferees have included funds for
the Directly Funded Minority Community Based Organization
program to fund grant applications from minority
organizations with a history of providing services to
communities of color to develop and expand HIV prevention
interventions and services targeted to highly impacted
minority men, women, youth and sub-populations. Funds are
also included to create grants under the CDC Community
Development Program to support needs assessments and enhance
community planning processes to integrate HIV, STD, TB,
substance abuse prevention and treatment, care and community
development within communities of color. Funds are to be
allocated for technical assistance programs for grantees
under the Directly Funded Minority CBO program, for Faith-
Based Initiative Programs including community based
organizations interested in developing coalitions and
partnerships with faith based institutions. Funds are also
provided for CDC's HIV surveillance activities to better
track the epidemic and target resources. These funds are to
be allocated based on program priorities identified in the
previous fiscal year as well as new priorities.
The conference agreement includes $126,528,000 for
tuberculosis (TB) instead of $120,364,000 as proposed by the
House and $113,413,000 as proposed by the Senate. The
conferees intend that the increase over the President's
request be used to reduce the number of foreign born TB cases
contributing to the U.S. caseload, strengthen domestic TB
control programs, and provide preventive therapy to
individuals who have latent TB infection and are high-risk
for developing active, infectious TB.
The conferees include $184,000 for Onondaga County, New
York Health Department to establish a prospective
tuberculosis control program for Central New York industries.
The conference agreement includes $148,256,000 for sexually
transmitted diseases instead of $136,743,000 as proposed by
the House and $135,978,000 as proposed by the Senate. The
conferees provide $6,000,000 over fiscal year 2000 funding
for chlamydia and $14,934,000 over fiscal year 2000 funding
for syphilis. Except for the administrative contribution
required by CDC, all of this increase for chlamydia must be
spent on appropriate services to patients to prevent
chlamydia infections using the existing partnership between
STD and family planning. The conferees recognize that given
the problem of re-infection and other factors, some of these
funds may be utilized to provide screening and treatment to
males as deemed appropriate by CDC.
The conference agreement includes $417,039,000 for chronic
and environmental diseases instead of $317,374,000 as
proposed by the House and $319,553,000 as proposed by the
Senate. Programs within this account are funded (including
salaries and expenses) at the following levels:
Environmental Disease Prevention:
Arctic populations...........................................$390,000
Asthma.....................................................27,906,362
Autism......................................................6,734,000
Birth defects..............................................17,608,000
Disabilities prevention....................................15,276,000
Environmental lab and health activities....................46,593,117
Fetal alcohol syndrome......................................9,551,843
Folic Acid..................................................2,500,000
Hanford Study...............................................1,679,000
Limb Loss...................................................3,352,000
Mild mental retardation.....................................4,396,000
Newborn Hearing Screening...................................6,315,576
Pfisteria...................................................9,081,000
Radiation...................................................1,949,000
Spina bifida................................................2,155,000
Volcanic emissions.............................................97,000
________________
Subtotal, Environmental.................................155,583,898
Chronic Disease Prevention & Health Promotion:
Arthritis and healthy aging................................11,889,000
Behavior risk factor surveillance...........................1,918,000
Cancer registries..........................................36,434,297
Cardiovascular diseases....................................35,038,825
Chronic fatigue syndrome....................................7,000,000
Colorectal cancer...........................................8,901,345
Community health promotion..................................7,164,000
Comprehensive cancer control................................3,096,000
Diabetes...................................................58,344,038
Epilepsy....................................................4,074,255
Iron overload.................................................495,000
Nutrition/Physical activity................................16,222,438
Oral health.................................................8,460,000
Prevention of teen pregnancies.............................13,258,000
Prostate cancer............................................11,173,000
School health program.......................................9,775,000
Skin cancer.................................................1,647,000
Tobacco (smoking and health)..............................103,355,034
Women's health..............................................1,500,000
Ovarian cancer..............................................2,625,870
Subtotal, Chronic.......................................342,371,102
Consolidated program administration.......................-80,916,000
________________
Total, Chronic & Environmental..........................417,039,000
Within the total provided for arthritis, the conferees urge
CDC to continue research, surveillance, and health
communication efforts, including the impact of lupus on
women, within the framework of the National Arthritis Action
Plan.
Within the total provided for cardiovascular diseases, the
conferees expect CDC to enhance professional and public
awareness outreach activities on pulmonary hypertension.
Within the total provided for nutrition/physical activity,
the conferees expect CDC to address overweight, obesity,
nutrition, and sedentary lifestyles by supporting state-based
programs, by training health professionals to recognize the
signs of obesity and recommend prevention activities, by
educating the public concerning overweight or obesity through
public education campaigns, and by developing strategies for
use at worksites and in community health and other community
settings.
Native American populations have a diabetes rate of four
times the national average with Hispanics following a close
second. The conferees urge CDC to fund pilot projects to
examine nutrition and prevention protocols for these
populations.
The conferees look forward to the completion of the
evidence-based report being developed by CDC and the Agency
for Healthcare Research and Quality that will assess the elements
of epilepsy treatment as they relate to clinical outcomes.
CDC is expected to disseminate the findings of this report to
people with epilepsy, health care professionals, and the
general public. The Director should be prepared to provide
the next steps required to implement an early intervention
strategy including diagnosis, treatment, and referral
recommendations at the fiscal year 2002 appropriations
hearing.
The conferees are encouraged that CDC plans to convene a
meeting to develop a national prostate cancer public health
agenda. The conferees urge the agency to continue its work
with voluntary public and professional organizations to
develop and implement a national educational and outreach
campaign with special attention to minority and under served
populations. CDC should be prepared to report on its prostate
cancer programs at the fiscal year 2002 appropriations
hearing.
The conferees urge CDC to give full and fair consideration
to a proposal to develop a diversified screening
demonstration project with the Dean and Betty Gallo Prostate
Cancer Center at the Cancer Center of New Jersey and the
Men's Health Network designed to determine effective methods
for encouraging men in the underserved population to
participate in colorectal screening and screening for other
high risk diseases.
The conferees urge CDC to provide additional support for
Johns Hopkins University to develop the Center for Limb Loss
Research.
The conferees include the following amounts for the
following projects and activities in fiscal year 2001.
Within the total provided for asthma, $213,000 is for the
Buffalo General Foundation, Buffalo, New York, for a study
examining the impact of air pollution on asthma rates and
respiratory illness and $921,000 is for Forum Health of
Youngstown, Ohio for a pediatric/adolescent asthma school
program.
Within the total provided for autism, $313,000 is for the
Marshall University autism center in Huntington, West
Virginia; $921,000 is for the New Jersey Epidemiologic
Surveillance and Integration Center for Children with Autism;
and $3,000,000 is for the Center of Excellence in Autism.
Within the total provided for birth defects, $147,000 is
for the Birth Defects Monitoring and Prevention Center at the
University of South Alabama and $461,000 is for the
University of Louisville Craniofacial Birth Defects Research
Center.
Within the total provided for cardiovascular diseases,
$46,000 is for the Sisters of Charity Health Care System and
Staten Island University Hospital's Heart Center; $500,000
for the Michael DeBakey Institute for Comparative
Cardiovascular Science; $929,000 is for the Kettering Medical
Center Healthy Hearts 2001 Initiative; and $4,500,000 is for
The Paul Coverdell National Acute Stroke Registry to track
and improve the delivery of care to patients with acute
stroke. The conferees direct CDC to consult with the National
Institute for Neurological Disorders and Stroke at the
National Institutes of Health, the Brain Attack Coalition,
and other professional organizations experienced in the
treatment of stroke, in developing specific data points for
collection as well as appropriate benchmarks for analyzing
care. The conferees further direct CDC to include hospitals,
universities, state and local health departments, and other
appropriate partners to design and pilot test prototypes,
that will measure the delivery of care to patients with acute
stroke in order to provide real-time data and analysis to
reduce death and disability from stroke and improve the
quality of life for acute stroke survivors.
Within the total provided for colorectal cancer, $184,000
is for the Sisters of Charity Health Care System to ensure
that patients have access to early detection of gastro-
intestinal cancers.
Within the total provided for community health promotion,
$553,000 is for the Baltimore City Health Department,
Maryland, to establish a Center for Chronic Diseases and
$900,000 is for the University of Texas, Dallas, for the
Southwestern Medical Center, National Multiple Sclerosis
Training Center.
Within the total provided for comprehensive cancer control,
$425,000 is for Miami-Dade County, Florida for the Health
Choice Network to administer the Jesse Trice Cancer
Prevention Project; $921,000 is for an Appalachian cancer
demonstration project at the East Tennessee State University
James H. Quillen College of Medicine to address cancer care
in the rural Appalachian region; $900,000 is for the
University of Rhode Island Cancer Prevention Research Center
to provide interactive interventions of at-risk populations;
and $850,000 is for the University of Texas M.D. Anderson
Cancer Center in Houston, Texas, for a comprehensive cancer
control program to address minority and medically undeserved
populations.
Within the total provided for diabetes, $230,000 for the
Fresno Community Hospital and Medical Center to support a
minority-focused diabetes outreach program; $213,000 is for
the Diabetes-Endocrinology Center of Western New York in
Buffalo for community education and outreach efforts to
improve the early detection, prevention and control of
diabetes; $276,000 is for a comprehensive diabetic research,
education and treatment program at Louisiana State Health
Sciences Center in Shreveport; $425,000 is for the University
of Puerto Rico to support surveillance, prevention research
and education programs at the center for diabetes in Puerto
Rico; $1,000,000 is for the National Diabetes Prevention
Center in Gallup, New Mexico to continue the prevention
center for American Indians; and $1,843,000 is for the Center
for Diabetes and Prevention Control at Texas Tech University
Health Sciences Center to provide a national model of
diabetes outreach, education, prevention and care.
Within the total provided for disabilities prevention,
$3,000,000 is to establish a paralysis information and
support center with the Christopher Reeve Paralysis
Foundation and to enhance efforts on the prevention of
secondary complications to improve outcomes and the quality
of life for people living with paralysis.
Within the total provided for environmental health
activities, $213,000 is for the San Antonio Metropolitan
Health District to expand an assessment of human exposure to
environmental contaminants near Kelly Air Force Base, Texas;
$400,000 is for the establishment of a National Mass
Fatalities Training Response Center, at Kirkwood Community
College in Cedar Rapids, Iowa; $500,000 is for the State of
Alaska's Department of Health and Social Services to study
environmental contaminants; $850,000 for a joint United
States/Vietnamese study on the effects of agent orange;
$850,000 for the University of North Carolina at Chapel Hill
to support additional research on animal modeling of chronic
human diseases such as cancer, fibrosis, hypertension, and
other diseases; and $1,800,000 for the Center for
Environmental Medicine and Toxicology at the University of
Mississippi Medical Center in Jackson, Mississippi.
Within the total provided for nutrition/physical activity,
$250,000 is for the National Youth Fitness and Obesity
Institute at the University of Northern Iowa; $298,000 is for
the University of North Carolina at Greensboro, North
Carolina, Institute for Health, Science and Society for the
Children's Healthy Life Skills Initiative; and $461,000 is
for the Grenada Lake Medical Center in Grenada, Mississippi
to conduct a demonstration on physical fitness in rural
areas.
Within the total provided for school health program,
$140,000 is for Proviso East High School in Maywood, Illinois
in collaboration with Loyola University of Chicago and the
Cook County Board of Health to improve the delivery of on-
site primary care, preventive care, and health outreach to
low-income parents and students in the community.
Within the total provided for tobacco, $900,000 is for the
University of Rhode Island Tobacco Cessation Program to
compare media and policy interventions on smoking cessation
and adoption of no smoking policies in the home.
The conference agreement includes $173,928,000 for breast
and cervical cancer screening instead of $160,941,000 as
proposed by the House and $167,016,000 as proposed by the
Senate. The conference agreement includes bill language to
allow the agency to expand the WISEWOMAN program to not more
than 15 States as proposed by the Senate. The House bill
allowed the agency to expand the program to not more than 10
States.
The conferees urge the CDC to give full and fair
consideration to proposals from Access Community Health
Network in Chicago for delivering breast and cervical cancer
screening and follow-up services to minority women.
The conferees include the following amounts for the
following projects and activities in fiscal year 2001:
--$92,000 to evaluate the high incidence of breast cancer
in DuPage County, Illinois;
--$213,000 for Marin County, California to evaluate the
high incidence of breast cancer in the San Francisco Bay
Area;
--$1,671,000 for the Healthcare Association of New York
State for a breast cancer demonstration project to develop an
integrated model for the delivery of comprehensive breast
cancer services in a coordinated setting.
The conference agreement includes $181,701,000 for
infectious diseases instead of $111,622,000 as proposed by
the House and $112,000,000 as proposed by the Senate. Within
the total provided, $25,000,000 is for the establishment of
partnerships between CDC and academic institutions and State
and local public health departments to carry out pilot
programs for antimicrobial resistance detection,
surveillance, education and prevention, and to conduct
research on resistance mechanisms and new or more effective
antimicrobial compounds.
The conferees commend CDC for its initiative to work with
hospitals in identifying and responding to the risk of
hospital-acquired infections and the emergence of
antimicrobial resistance in the pediatric population,
including its successful development of the largest hospital-
based infection control network in the country. The conferees
encourage CDC to continue its effort to work with pediatric
hospital networks to improve infection control efforts for
children, particularly high-risk children.
Within the total provided, $25,000,000 is to continue
planned activities and to expand efforts to control the West
Nile virus, an increase of $20,000,000 above the President's
request. The conferees direct CDC to ensure an equitable
distribution of these funds based on the impact of the West
Nile virus in particular states and localities during
calendar year 2000. The criteria should include: the date of
first positive findings, intensity of wildlife transmission,
occurrence of human illness, geographic extent of positive
findings, laboratory testing/activities, and employment of
control measures, including spraying.
Also within the total provided is $34,577,000 for NEDSS/EID
and an increase of $4,000,000 for malaria programs.
The conferees urge CDC to give full and fair consideration
to a proposal by Advance Paradigm to demonstrate the role of
provider utilization of information technology to improve
patient safety through management of polypharmacy outcomes.
The conferees include the following amounts for the
following projects and activities in fiscal year 2001:
--$149,000 for Case Western Reserve University, Cleveland,
Ohio for prion disease surveillance;
--$250,000 for the Institute for Clinical Evaluation for
the reduction of medical errors through the development and
demonstration of virtual reality medical technology
simulation for training health care workers in medical
procedures;
--$300,000 for the Fletcher Allen Health Care, Burlington,
Vermont for a demonstration to reduce medical errors;
--$500,000 for the Iowa Department of Public Health for a
demonstration to identify and develop strategies to reduce
adverse medical events;
--$961,000 for the University of Texas Medical Branch,
Galveston, Texas, Tyler Border Infectious Disease Monitoring
Program;
--$921,000 for the Emerging Infectious Diseases Center at
the University of New Mexico in Albuquerque to develop a
network-based surveillance system; and
--$1,843,000 to develop a comprehensive, statewide
electronic public health reporting system in the State of
Delaware.
The conference agreement includes $34,933,000 for lead
poisoning prevention instead of $31,019,000 as proposed by
the House and $30,978,000 as proposed by the Senate. CDC is
encouraged to work with Early Head Start in developing a
strategy identify and target resources for childhood lead
poisoning prevention to high-risk populations.
The conference agreement includes $77,332,000 for injury
control instead of $66,298,000 as proposed by the House and
$69,000,000 as proposed by the Senate.
The conferees have provided an additional $3,000,000 for
CDC to strengthen its focus on violence by supporting
initiatives directed at the prevention of physical and
emotional injuries associated with child abuse and neglect.
The conferees note that CDC convened a group of experts on
child maltreatment to identify future directions for
prevention. Increased funds are provided to begin to improve
information on child maltreatment through mechanisms such as
state-based surveillance, the development of uniform
definitions, and survey information from victims and
perpetrators. The conferees also support the evaluation and
dissemination of effective interventions and urge CDC to
develop and distribute an evaluation primer, a resource guide
for evaluated child maltreatment interventions, and
educational materials on child maltreatment prevention.
The conferees include $2,000,000 to support a joint effort
by CDC and the Consumer Product Safety Commission to identify
products that contribute to common injuries. The conferees
understand that this effort includes collecting information
from hospitals that currently offer 24-hour trauma service.
The conferees agree that any research and/or study undertaken
shall address all products contributing to injuries found in
these areas and that all existing restrictions on CDC funding
and the Consumer Product Safety Commission apply to all
aspects of this effort.
CDC is urged to conduct evaluation research on sleepiness,
sleep deprivation, and injury prevention associated with
fatigue.
The conferees concur with Senate report language regarding
the development of population-based injury reporting systems
and recognize the efforts of the University of Maryland,
College Park.
The conferees include the following amounts for the
following projects and activities in fiscal year 2001:
--$92,000 for the Rebuild program at Inova Fairfax Hospital
that will enable trauma system doctors and nurses to work
effectively with the families of trauma victims;
--$200,000 for the National Children's Center of Rural
Agricultural Health;
--$250,000 for the American Trauma Society for a trauma
information and exchange program;
--$425,000 for the National SAFE KIDS Campaign, Washington,
DC to improve child health through parental training and
technical assistance in public housing sites and communities;
--$750,000 for an Alaska Injury Prevention Center of which
$250,000 is for collaboration with the State of Alaska
Department of Health and Social Services and $500,000 is to
develop a statewide childhood injury prevention program;
--$850,000 for the Kennedy Krieger National Center for
Research on Behavior of Children and Youth, Baltimore,
Maryland for a youth violence prevention project; and
--$921,000 for the Save A Life Foundation to expand the
training of its basic life supporting first aid program.
The conference agreement includes $119,375,000 for the
national occupational safety and health program instead of
$86,346,000 as proposed by the House and $105,000,000 as
proposed by the Senate.
The conferees provide an increase over the request of
$10,000,000 for the National Occupational Research Agenda,
$9,000,000 for respirator research and personal protective
technology, and $1,000,000 for Education and Resource
Centers.
The conferees urge NIOSH to be supportive of developing a
Pacific basin focus at the University of Hawaii at Hilo.
The conferees include $723,000 for Purdue University in
West Lafayette, Indiana, to support the Construction Safety
Alliance for a national program in construction safety and
health.
The conference agreement includes $174,851,000 for epidemic
services instead of $155,338,000 as proposed by the House and
$30,254,000 as proposed by the Senate. Within the total
provided, $125,000,000 is for a National Campaign to Change
Children's Health Behaviors as described in the House report,
including promoting mental health. The campaign is designed
to clearly communicate messages that will help kids develop
habits that foster good health over a lifetime. The conferees
expect the goals of the campaign will also address the
growing problem of obesity in this country. By displacing the
opportunity for young people to make bad choices during
after-school and weekend hours (such as being physically
inactive) with opportunities to engage in positive goal-
directed activities (such as sports and other physical
activity) the campaign will reduce the proportion of children
and adolescents who are overweight and obese.
The conferees commend CDC's leadership role in landmine
victim assistance programs and have provided an additional
$5,000,000 to support expansion of the landmine survivor
program as well as the partnership with the Landmine
Survivors Network to further develop peer support networks
that address the rehabilitative and socioeconomic needs of
landmine victims in mine affected countries.
The agreement includes $14,000,000 for the safe motherhood
initiative. The conferees urge CDC to further its efforts to
prevent deaths and complications during pregnancy and reduce
racial disparities, with special focus on complications
related to a lack of access to prenatal care and community
support.
The conferees include the following amounts for the
following projects and activities in fiscal year 2001:
--$9,000 for the Cross Road Foundation for a pilot project
to sponsor singles mother self-help groups to improve
parenting skills;
--$37,000 for Victory Memorial Hospital in Brooklyn, New
York to expand its prenatal program for uninsured, pregnant
women;
--$100,000 for the Northern New Jersey Maternal Child
Health Consortium;
--$184,000 for the Children's Hospital of Buffalo for
activities related to intestinal motility disorders in
infants;
--$500,000 for the University Medical Center of Southern
Nevada for Maternal and Neonatal Intensive Care;
--$900,000 for Sudden Infant Death Syndrome Resources,
Inc., Missouri Bootheel Healthy Start project;
--$1,000,000 for the Prince George's County Health
Department for Infant Mortality Prevention;
--$1,020,000 for Jackson State University, Office of
Research and Development to establish an epidemiological
research institute;
--$1,704,000 is for the University of Arizona, College of
Public Health to continue comprehensive research and
evaluation of the unique public health risks along the U.S.-
Mexico border; and
--$3,001,000 for the Lawton and Rhea Chiles Center for
Healthy Mothers and Babies Friendly Access program to improve
the quality of perinatal health service delivery.
The conference agreement includes $13,593,000 for
prevention research as proposed by the House instead of
$13,386,000 as proposed by the Senate.
The conference agreement includes $35,009,000 for health
disparities demonstrations instead of $32,184,000 as proposed
by the House and $27,000,000 as proposed by the Senate.
The conference agreement includes $669,130,000 for program
administration instead of $648,774,000 as proposed by the
House and $626,228,000 as proposed by the Senate.
The conferees do not include language proposed by the
Senate to reduce administrative expenses of the CDC. The
House bill contained no similar provision.
CATALOG OF FEDERAL DOMESTIC ASSISTANCE
Popular Name:
Disability and Health
Objectives:
To (1) Provide a national focus for the prevention of
secondary conditions in persons within selected disability domains
including mobility, personal care, communication, and learning; (2)
build State capacity to coordinate program activities and assess the
magnitude of disability in States; (3) employ epidemiological methods to
set priorities and direct health promotion interventions for persons
with disabilities; (4) conduct research projects to understand secondary
conditions and measure the impact of the environment on the lives of
persons with disabilities, and conduct studies on the effectiveness of
interventions in targeted groups of persons with disabilities; 5) fund a
national limb loss information center and limb loss research; 6) fund a
national information center on physical activity for persons with
disabilities; and fund a national paralysis and quality of life
information and support center.
Applicant Eligibility:
Based on available funding for fiscal year
2000, CDC issued additional competitive program announcements for new
research grants in fiscal year 2000 and for a national limb loss
information center. All other projects listed in this notice will be
eligible for noncompeting continuation awards in fiscal year 2001.
Requests for noncompeting extension applications are being solicited
from the established state capacity projects. State capacity
cooperative agreements: Eligible applicants for these noncompeting
continuation awards will be the currently funded States. These
recipients include the official public health departments of States or
other State agencies and departments that are determined by senior State
officials to lead and coordinate this program. Eligibility for this
program in the future when new competitive announcements are announced
in fiscal year 2002 will continue to include State health departments or
other official organizational authority (agency or instrumentality) of
States, including DC, Puerto
Rico, and any territory or possession of the United States. Research
Grants: Eligible applicants for competing applications in fiscal year
2000 was through the issuance of a competitive program announcement
which include public and private nonprofit entities, including
universities, university-affiliated systems including not-for-profit
medical centers, research institutions and rehabilitation hospitals,
disability service groups such as advocacy and voluntary organizations
and independent living centers, and federally recognized Indian Tribal
Governments. For the new limb loss research and physical activity
projects, new applications will not be solicited for these programs as
they are in the third year of their respective four year project
periods. A new announcement for an information and support center on
paralysis and quality of life will be issued in fiscal year 2001 to a
sole source organization.
Beneficiary Eligibility:
In addition to the eligible applicants,
other groups who will receive benefits from the program include persons
with disabilities and family members of persons with disabilities,
persons with limb loss, minority populations, refugees, infants,
children, youth, adults, senior citizens, women, all educational levels,
all income levels, urban, suburban, and rural populations,
health/rehabilitation professionals, scientists, educators, and
researchers.
Credentials/Documentation:
State capacity applicants documented
in their fiscal year 2000 continuation applications and for their fiscal
year 2001 extension applications the need for assistance, indicated the
objectives of their projects, presented their approaches to meet set
objectives, and outlined the method of operation. Current research
project grants requesting funding and/or additional time as project
extensions presented their capacity to address and be responsive to the
requirements of their respective application guidelines. Costs will be
determined in accordance with OMB Circular No. A-87 for State and
local
governments and federally-recognized Indian Tribal Governments. For
nonprofit recipients, costs will be determined in accordance with HHS
Regulation 45 CFR 74.
Preapplication Coordination:
As new competitive funding becomes
available for this program, pre-application coordination will not be
required. However applicants will be encouraged to submit a non-binding
letter of intent 30 days before the deadline date. State capacity
projects are subject to E.O. 12372, "Intergovernmental Review of Federal
Programs." Applicants should consult the office or officials designated
as the single point of contact in their State for more information on
the process the State requires in applying for financial assistance, if
the State has selected the program for review. Research grant projects
applicants in future years will not be subject to E.O. 12372.
Application Procedure:
When this program is re-announced for
competition in the fiscal year 2002, application forms for State
capacity projects will be available from, and be submitted to the
Procurement and Grants Office, Grants Management Branch, Centers for
Disease Control and Prevention, 2920 Brandywine Road, Room 3000,
Atlanta, GA 30341. The standard application forms as furnished by the
CDC and required by 45 CFR 92, must be used for this program. This
program is subject to the provisions set forth in 45 CFR 92, for State
and local governments and OMB Circular No. A-110 for nonprofit
organizations.
Award Procedure:
State capacity cooperative agreement competitive
awards and Research project grant competitive awards are determined by
an internal objective committee review process at CDC. At such times,
awards will be based on evaluation criteria set forth in the respective
Program Announcements, the availability of funds, and such other
significant factors as deemed necessary and appropriate by CDC. Future
awards for State capacity projects will be issued for an expected
project period of four years. Future awards for Research project grants
not are expected to be issued until fiscal year 2003 given the three
year funding cycle for those projects first funded in fiscal year 2000.
The Notices of Grant Award (PHS Form 5152-1) will indicate financial
support for the first budget year, allocations of Federal funds by
budget category, and special conditions, if any.
Deadlines:
Contact the Headquarters Office for application
deadline information.
Range of Approval/Disapproval Time:
Between 65 to 95 days from
the deadline date for submission of applications.
Appeals:
None.
Renewals:
All current State capacity projects will complete their
respective project periods in March 2002. It is anticipated that in
October 2001, a new competition for State capacity awards will be
conducted through an issued Program Announcement. Competition for new
or additional State projects will be based on future appropriations. The
current research project grants will conclude their respective project
periods during the period in September 2003, and no new Research grants
are expected to be announced until fiscal year 2003. The National Limb
Loss Information Center, the Limb Loss Research and Epidemiology Grant
Project, and the National Center on Physical Activity and Disability
will be re-funded in fiscal year 2001 for continuation years within
their respective project periods. The projects on Limb Loss Research
and the National Center on Physical Activity and Disability are funded
for four year project periods ending in March 2003. The Limb Loss
Information Center is funded through September 2003.
Criteria for Selecting Proposals:
It is expected that competitive
announcements will be issued for State capacity projects early in fiscal
year 2002. New Research grant projects will not be re-announced and
awarded until late in fiscal year 2003. In these cases, applications
are reviewed based on evaluation criteria explicit in the respective
Program Announcements. Applications must address demonstrated program
need, the magnitude of the problem, the project management work plan,
collaborative associations, and the approach toward setting and meeting
overall project objectives and time frames. These competitive
applications would also be evaluated on the capacity of the applicant to
demonstrate effective collaborations with other agencies and data
sources critical to preventing secondary conditions, identifying and
addressing health promotion needs for persons with disabilities,
denoting the capability of the project to address minority and
low-income populations in the prevention of secondary conditions,
promoting accessibility to all program services for persons with
disabilities, and offering sound proposals toward development of surveys
and surveillance for useful data bases within outlined targeted
disability activities.
Examples of Funded Projects:
The majority of awards for State
capacity projects in the past have been made to State health departments
to develop a Statewide focus for the prevention of secondary
disabilities and health promotion for persons with disabilities within a
structured State office, to establish an advisory body to guide the
development of planning and make recommendations to fill gaps in
prevention, to establish and build partnerships with universities and
advocacy/voluntary organizations for public health surveillance and
health promotion delivery programs for persons with disabilities. and to
conduct surveillance and implement community projects in the targeted
disability domains. Research grantees have accessed data and service
programs to identify persons with disabilities, conducted surveillance,
and implemented studies and interventions designed to prevent selected
or a range of secondary conditions related to cost effectiveness,
measurement of participation in the environment of persons with
disabilities, women, minorities, and adolescents and older citizens with
disabilities. Current Research grantees include universities and
rehabilitation hospitals. The National Limb Loss Information Center has
worked to build, expand, and utilize a national network for providing
information, referral, and peer counseling programs for persons with
limb loss. The Limb Loss Research and Epidemiology project includes
both a disability service organization and a leading research
university. The National Center on Physical Activity and Disability is
based at a major research university with key collaborating partners in
rehabilitation, education, web site development and linkages, library
capacity, and physical accessibility.
Range and Average of Financial Assistance:
The average of awards
using fiscal year 2000 and 2001 funds for the 14 State capacity projects
that received continuation awards was $333,600 and $278,000 (for 9
months) respectively. The average award for the 11 research project
grants receiving competitive funds in fiscal year 2000 was $311,300.
Funding levels for all awards in fiscal year 2002 will be based on
future appropriatons.
- 10.551 Food Stamps;
- 64.109 Veterans Compensation for Service-Connected Disability;
- 64.116 Vocational Rehabilitation for Disabled Veterans;
- 93.135 Centers for Research and Demonstration for Health Promotion and Disease Prevention;
- 93.136 Injury Prevention and Control Research and State and Community Based Programs;
- 93.224 Community Health Centers;
- 93.667 Social Services Block Grant (SSBG);
- 93.988 Cooperative Agreements for State-Based Diabetes
Control Programs and Evaluation of Surveillance Systems;
- 96.001 Social
Security: Disability Insurance.
The new program announcements and the
fiscal year 2000 and 2001 continuation awards recognized a shift in
program focus as to the purpose and prescribed activities for both State
capacity cooperative agreements and research project grants within their
respective project periods. These projects emphasize the prevention of
secondary conditions and health promotion for persons with disabilities.
The national limb loss information center will provide information and
referral regarding these issues. For fiscal years 2000 and 2001, the 14
State capacity projects expanded program visibility and prominence by
building the State emphasis on promoting health and wellness for persons
with disabilities and the prevention of secondary conditions. This will
be accomplished through strategic planning, advisory and advocacy input,
policy development, enhancing university and voluntary organization
partnerships for data access and client service opportunities, data
analysis, conducting State-level surveys for determining physical
limitations among its population, delivering professional and public
education, and the inclusion of program evaluation measures. A new
State program announcement will be issued in fiscal year 2002. For
fiscal years 2000 and 2001, the Research grantees will implement their
respective protocols and studies. In fiscal years 2000 and 2001, the
currently funded National Limb Loss Information Center and National
Center on Physical Activity and Disability continued their expansion of
their outreach and response capacity to directly support and refer
identified needs of persons and organizations inquiring about these
issues of concern and interest.
Federal Agency:
CENTERS FOR DISEASE CONTROL AND PREVENTION,
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Type of Assistance:
Project Grants; Project Grants (Cooperative
Agreements).
Obligations:
(Cooperative Agreements) State capacity projects: FY
00 $4,675,000; FY 01 est $3,890,000; and FY 02 est $5,000,000. (Grants)
Research Projects: FY 00 $3,425,000; FY 01 est $3,425,000; and FY 02 est
$3,425,000. (Cooperative Agreement) National Limb Loss Information
Center: FY 00 $1,400,000; FY 01 est $1,400,000; and FY 02 est
$1,400,000. (Grants) Limb Loss Research and Epidemiology: FY 00
$500,000; FY 01 est $500,000; and FY 02 est $500,000. (Cooperative
Agreement) National Center on Physical Activity and Disability: FY 00
$750,000; FY 01 est $750,000; and FY 02 est $750,000.
Budget Account Number:
75-0943-0-1-551.
Authorization:
Public Health Service Act, Section 301(a) and
Section 317, as amended, 42 U.S.C. 241(a); 42 U.S.C. 247(b).
Regulations, Guidelines, and Literature:
None.
Regional or Local Office:
Not applicable.
Headquarters Office:
Program Contact: Joseph B. Smith, Disability
and Health Branch, National Center for Environmental Health, Centers for
Disease Control and Prevention (CDC), 4770 Buford Highway, Building 101,
Mailstop (F-35), Atlanta, GA 30341. Phone: (770) 488-7082. Fax:
(770) 488-7075. E-Mail: jos4@cdc.gov. Grants Management Contact: Ms.
Alene Westgate, Grants Management Branch, Procurement and Grants Office,
Centers for Disease Control and Prevention (CDC), 2920 Brandywine Road
(Colgate Building), Room 3000, Atlanta, GA 30341. Phone: (770)
488-2721. E-Mail: anw3@cdc.gov
Web Site Address:
http://www.cdc.gov
(See Appendix IV for more contact info.)
Formula and Matching Requirements:
These programs have no
statutory matching requirements, however applicants are encouraged to
assume and document part of project costs.
Length and Time Phasing of Assistance:
State capacity project
applicants will receive financial assistance in fiscal year 2001 for a
nine month close-out extension of their project periods through March
2002. The new competitive research grants funded in fiscal year 2000
will have three year project periods through September 2003. Other
future solicitations (when announced) will indicate the length of the
project periods for each of these programs. The projects funded for
Limb Loss Research and Epidemiology, the National Limb Loss Information
Center, and the National Center on Physical Activity and Disability each
received awards covering 4-year project periods concluding in fiscal
year 2003.
Uses and Use Restrictions:
CDC issued continuation awards in
fiscal year 2000 for 14 State capacity cooperative agreements and 11
research project grants to address the prevention of secondary
conditions and health promotion for persons with disabilities. State
capacity cooperative agreements: These awards are providing financial
assistance to: (1) Establish and/or sustain State offices of disability
and health to promote the visibility of preventing secondary conditions
as a State public health priority, and serve as a technical assistance
resource and statewide focus for the prevention of secondary conditions;
(2) support an advisory function to coordinate and provide policy and
program direction guidance in the State; (3) develop and/or implement a
State strategic plan or policy instrument for health promotion for
persons with disabilities; (4) maintain and refine prescribed public
health surveillance or survey activities for disability domains of
mobility, personal care, communications, and learning in order to
implement prevention efforts and program evaluation activities; 5)
provide technical assistance to communities; and 6) promote education
and health promotion programs for persons with disabilities, conduct
training of health professionals, and facilitate access to services for
persons with disabilities. Research project grants: Financial assistance
under this program is being used to: 1) Implement and evaluate programs
to identify and quantify preventable secondary conditions within
disability domains which include physical, medical, cognitive,
emotional, and/or psychosocial conditions and their prevention; 2)
determine the risk and protective factors in specified populations of
persons who have a disability; 2) measure the effectiveness and costs of
preventive interventions; and 3) develop measurements of the environment
that can facilitate or hinder access to participation for persons with a
disability. National Limb Loss Information Center Cooperative
Agreements: Financial assistance has been awarded to operate a national
clearinghouse to provide educational material and self-help guidance to
persons with limb loss and their families, and develop a peer visitation
training initiative for the conduct of education and training sessions
in hospitals, rehabilitation facilities, and support groups. The
National Center on Physical Activity and Disability provides multiple
sources of information and references on a vast array of inquiries on
exercise and health promotion activities. In these cases, project funds
may not be used to supplant State, local, or institutional funds
available for these activities, or for construction costs, or to
purchase facilities or space. Grantees may enter into contracts as
necessary to help achieve the objectives of their respective programs.
As a new project in 200
