**U.S. Department of Health and Human Services**

**Health Resources and Services Administration**

**Maternal and Child Health Bureau**

**Maternal and Child Health Research Program**

***R40: Maternal and Child Health Research Program (MCHR)***

***New Competition***

*HRSA-07-004*

*Catalog of Federal Domestic Assistance (CFDA) No. 93.110*

**PROGRAM GUIDANCE**

Fiscal Year 2007 []{.mark}

**Application Due Date: July 24, 2006**

**Release Date: *June 6, 2006***

**Date of Issuance: June 6*, 2006 ***

[Contact Names]{.underline}:

R40 Extramural MCH Research Program: Rita Haggerty or Hae Young Park

Title, Office: Program Officers; Division of Research, Training and
Education

Telephone: (301) 443-2207

Fax: (301) 443-4842

Authority: Title V, Section 501(a)(2); 42 U.S.C. 701(a)(2) of the Social
Security Act, as amended.

***EXECUTIVE SUMMARY***

***Maternal and Child Health Research Program (MCHR)***

Thank you for your interest in the **R40 MCHR Competition.** Grant
support is available from the Division of Research, Training and
Education (DRTE), part of the Maternal and Child Health Bureau (MCHB) of
the Health Resources and Services Administration (HRSA) in the U.S.
Department of Health and Human Services (DHHS). We are aware that
preparation of this application will involve a considerable commitment
of time and energy. **Please read the guidance carefully before
completing the application.**

This guidance includes instructions for 2 separate grant competitions:

**A) R40 Extramural MCH Research Program** supports applied research
relating to maternal and child health services, that have the potential
to improve health services and delivery of care for maternal and child
health populations.

**B) R40 Secondary Data Analysis Studies** supports applied research
relating to maternal and child health services that utilizes exclusively
the analysis of existing secondary data. These projects should have the
potential to improve health services and delivery of care for maternal
and child health populations.

**Qualified Applicants:** As cited in 42 CFR Part 51a.3(b), only public
and nonprofit institutions of higher learning and public or private
nonprofit agencies engaged in research or in programs relating to
maternal and child health and/or services for children with special
health care needs are eligible. If otherwise eligible, faith-based and
community organizations are eligible to apply.

**Number of Grants and** **Extramural MCH Research**-Subject to the
availability of

**Funds Available Per Year:** appropriations, approximately \$1.2
million will be available to fund approximately 4 grants per year for up
to 4 years (the ceiling amount of an individual award is \$300,000 total
cost per year).

> **Secondary Data Analysis Studies** -Subject to the availability of
> appropriations, approximately \$300,000 is available to fund up to 3
> grants for one year (the ceiling amount of an individual award is
> \$100,000).

**Application Due Date:** July 24, 2006

Project Period: Extramural MCH Research -Approved projects will be
funded effective January 1, 2007 and will be awarded project periods of
up to four years.

Secondary Data Analysis Studies- Approved projects will be funded
effective January 1, 2007 and will be awarded a project period of one
year.

**Programmatic Assistance**

Additional information related to the overall program issues or
technical assistance may be obtained by contacting:

Rita Haggerty or Hae Young Park

> Maternal and Child Health Bureau
>
> 5600 Fishers Lane, Room 18A-55, Rockville, MD 20857
>
> Telephone: (301) 443-2207; Fax: (301) 443-4842
>
> E-Mail: <rhaggerty@hrsa.gov> or <hpark@hrsa.gov>

**Business, Administrative and Fiscal Inquiries**

Applicants may obtain additional information regarding business,
administrative, or fiscal issues related to this grant announcement by
contacting:

Jackie Whitaker

> Lead Grants Management Specialist

DHHS/HRSA/OFAM

Division of Grants Management Operations

> Research and Training Branch
>
> 5600 Fishers Lane, Room 11A-16

Rockville, MD 20857

Telephone: (301) 443-4893

> E-mail: [jwhitaker@hrsa.gov](mailto:jking@hrsa.gov)

**GUIDANCE TABLE OF CONTENTS**

I. Funding Opportunity Description 7

1\. Purpose 7

2\. Background 7

II\. Award Information 9

1\. Type of Award 9

2\. Summary of Funding 9

III\. Eligibility Information 9

1\. Eligible Applicants 9

2\. Cost Sharing/Matching 9

3\. Other 10

IV\. Application and Submission Information 10

1\. Address to Request Application Package 10

Application Materials 10

2\. Content and Form of Application Submission 11

Application Format Requirements 11

Application Format 11

SF 424 R&R -- Table of Contents 12

i\. Application Face Page 16

ii\. Table of Contents 16

iii\. Application Checklist 16

iv\. Budget 16

v\. Budget Justification 17

vi\. Staffing Plan and Personnel Requirements 19

vii\. Assurances 19

viii.Certifications 20

ix\. Project Abstract 20

x\. Program Narrative/Research Plan 21

xi\. Appendices 25

3\. Submission Dates and Times 25

a\. Application Due Date 25

b\. Late Applications 26

4\. Intergovernmental Review 26

5\. Funding Restrictions 26

6\. Other Submission Requirements 26

V. Application Review Information 28

1\. Review Criteria 28

2\. Review and Selection Process 31

3\. Anticipated Announcement and Award Dates 32

VI\. Award Administration Information 32

1\. Award Notices 32

2\. Administrative and National Policy Requirements 32

3\. Reporting 33

Performance Standards for Special Projects of Regional or National

Significance (SPRANS) and Other MCHB Discretionary Projects 34

1\. Performance Measures and Program Data 34

2\. Post-Award Reporting 34

VII\. Agency Contacts 34

VIII\. Other Information 36

IX\. Tips for Writing A Strong Application 37

APPENDIX A: HRSA's ELECTRONIC SUBMISSION USE GUIDE 38

1\. Introduction 40

1.1. Document Purpose and Scope 40

1.2. Document Organization and Version Control 40

2\. Noncompeting Continuation Application 40

2.1 Process Overview 40

2.2 Grantee Organization Needs to Register with Grants.gov

(if not already registered) -- See Appendix B 41

2.3 Project Director and Authorizing Official Need to Register with

HRSA EHBs (if not already registered) 42

2.4 Apply Through Grants.gov 42

2.4.1 Find Funding Opportunity 42

2.4.2 Download Application Package 43

2.4.3 Complete Application 43

2.4.4 Submit Application 43

2.4.5 Verify Status of Application 43

2.5 Verify in HRSA Electronic Handbooks 44

2.5.1 Verify Status of Application 44

2.5.2 Manage Access to Your Application 44

2.5.3 Check Validation Errors 45

2.5.4 Fix Errors and Complete Application 45

2.5.5 Submit Application 45

2.6 Submit Signed Face Page 45

3 Competing Application 45

3.1 Process Overview 45

3.2 Grantee Organization Needs to Register with Grants.gov

(if not already registered) -- See Appendix B 46

3.3 Applying Through Grants.gov 46

3.3.1 Find Funding Opportunity 46

3.3.2 Download Application Package 47

3.3.3 Complete Application 47

3.3.4 Submit Application 47

3.3.5 Verify Status of Application 47

3.4 Submit Signed Face Page 48

4 General Instructions for Application Submission 48

4.1 Narrative Attachment Guidelines 48

4.1.1 Font 48

4.1.2 Paper Size and Margins 49

4.1.3 Names 49

4.1.4 Section Headings 49

4.1.5 Page Numbering 49

4.1.6 Allowable Attachment or Document Types 49

4.2 Application Content Order (Table of Contents) 49

4.3 Page Limit 50

5\. Customer Support Information 50

5.1.1 Grants.gov Customer Support 50

5.1.2 HRSA Call Center 50

5.1.3 HRSA Program Support 50

6\. FAQs 51

6.1 Software 51

6.1.1 What are the software requirements for using Grants.gov 51

6.1.2 Why can't I download PureEdge Viewer onto my machine? 51

> 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What
> do
>
> I do if I use only a Macintosh? 51

6.1.4 What are the software requirements for HRSA EHBs? 52

> 6.1.5 What are the system requirements for using HRSA EHBs on a
>
> Macintosh computer? 52

6.2 Application Receipt 52

> 6.2.1 What will be the receipt date -- the date the application is
> stamped as
>
> received by Grants.gov or the date the data is received by HRSA? 52
>
> 6.2.2 When do I need to submit my application 52
>
> 6.2.3 What emails can I expect once I submit my application?
>
> Is email reliable? 53
>
> 6.2.4 If a resubmission is required because of Grants.gov system
> problems,
>
> will these be considered "late?" 53

6.3 Application Submission 54

> 6.3.1 How Can I make sure that my electronic application is presented
> in the
>
> right order for objective review? 54

6.4 Grants.gov 54

APPENDIX B -- REGISTERING AND APPLYING THROUGH GRANTS.GOV 55

APPENDIX C: Instructions for the SF-424 R&R 60

APPENDIX D: Sample Forms 80

APPENDIX E: MCHB Strategic Research Issues: FYs 2004-2009 86

APPENDIX F: MCHB Performance Measures and OMB Approved Data Forms 92

APPENDIX G: Menu of Suggested Key Words for Project Abstracts 112

**I. Funding Opportunity Description**

**1. [Purpose, Extramural MCH Research (MCHR) Program]{.underline}**

The R40 Extramural MCH Research Program supports applied research
relating to maternal and child health services including services for
children with special health care needs, which show promise of
substantial contribution to advancement of the current knowledge pool,
and when used in states and communities should result in health and
health services improvements. Findings from the research supported by
the MCH Research Program are expected to have potential for application
in health care delivery programs for mothers and children. Research
studies that specifically address issues related to MCHB investments and
programs are strongly encouraged.

The Maternal and Child Health Bureau periodically re-examines its
applied research agenda. In June 2003, the Bureau initiated the process
of updating its research agenda by convening a work group to exchange
information regarding the current and emerging issues of importance in
the field. Members of the work group represented state and federal
agencies, institutions of higher learning and other organizations, who
are prominent in the field and whose work has helped to advance the
field. Based on the individual recommendations of these individuals, the
Bureau developed four strategic research issues (see Appendix D). The
Bureau strongly encourages research studies that specifically address
issues related to MCHB investments and programs. Addressing one of the
four strategic research issues is a review criterion worth up to 10
points in the overall score of an application.

**[Purpose, Secondary Data Analysis Studies (SDAS)]{.underline}**

Within the R40 MCH Research Program, funding is available in FY2007 to
support three (3) studies that analyze existing secondary MCH data.

**2. Background**

**Maternal and Child Health Bureau and Title V of the Social Security
Act:** In 1935, Congress enacted Title V of the Social Security Act
authorizing the Maternal and Child Health Services Programs. This
remarkable legislation has provided a foundation and structure for
assuring the health of mothers and children in our nation for more than
65 years. Title V was designed to improve health and assure access to
high quality health services for present and future generations of
mothers, infants, children and adolescents, including those with
disabilities and chronic illnesses, with special attention to those of
low income or with limited availability of health services.

> Today, Title V is administered by the Maternal and Child Health Bureau
> (MCHB) which is a part of the Health Resources and Services
> Administration (HRSA) in the U.S. Department of Health and Human
> Services (DHHS). Under Title V of the Social Security Act, the
> Maternal and Child Health Services Block Grant program has three
> components---Formula Block Grants to States, Special Projects of
> Regional and National Significance (SPRANS) and Community Integrated
> Service Systems (CISS) grants. Using these authorities, the MCHB has
> forged partnerships with States, the academic community, health
> professionals, advocates, communities and families to better serve the
> needs of our nation's children.
>
> The mission of MCHB is to provide national leadership and to work, in
> partnership with States, communities, public-private partners, and
> families to strengthen the maternal and child health (MCH)
> infrastructure, assure the availability of medical homes, and build
> the knowledge and human resources, in order to assure continued
> improvement in the health, safety, and well-being of the MCH
> population. The MCH population includes all America's women, infants,
> children, adolescents and their families, including fathers and
> children with special health care needs (CSHCN).
>
> The goals of MCHB are:

1\) *Provide National Leadership for Maternal and Child Health***---**To
provide national leadership by creating a shared vision and goals for
MCH, strengthening the knowledge base, forging MCH partnerships,
promoting family participation in care and providing graduate level and
continuing education training to assure interdisciplinary MCH public
health leadership nationwide;

2\) *Eliminate Health Barriers and Disparities*---To develop and promote
health services and systems of care designed to eliminate disparities
and barriers across the MCH population and train an MCH workforce that
is culturally competent and reflects an increasingly diverse population;

3\) *Assure Quality of Care*---To build analytic capacity to assess and
assure quality of care, develop and promote health services and systems
designed to improve quality of care and assure appropriate follow-up
services; and

4\) *Improve the Health Infrastructure and Systems of Care*---To build
analytic capacity for assessment, planning and evaluation, to use the
best available evidence to develop and promote guidelines and best
practices, and assist states and communities to plan and develop
comprehensive, integrated health service systems.

> **The Extramural Maternal and Child Health Research Program (MCHR)**:
> The Maternal and Child Health Research Program is authorized by Title
> V, Section 501(a)(2); 42 U.S.C. 701(a)(2) of the Social Security Act.
> The program is administered by the Division of Research, Training and
> Education, Maternal and Child Health Bureau (MCHB), Health Resources
> and Services Administration (HRSA). The MCH Research Program, built on
> almost 40 years of experience, has supported ground-breaking
> investigations which have significantly influenced clinical
> management, organization and delivery of health care services,
> preventive care and early intervention for the maternal and child
> health population.

**II. AWARD INFORMATION**

**1. Type of Award**

Funding will be provided in the form of a grant for the R40 Extramural
Maternal and Child Health Research Program and the R40 Secondary Data
Analysis Studies. Applicants cannot apply to both categories
simultaneously.

**2. Summary of Funding**

**Extramural Maternal and Child Health Research Program (MCHR)**

> The MCH Research Program will provide funding for projects for periods
> up to four years (Federal Fiscal Years 2007 -- 2010). Subject to the
> availability of appropriations, approximately \$1.2 million is
> expected to be available to fund approximately 4 grantees (Ceiling
> amount of an individual award is \$300,000 total cost per year).
>
> Funding beyond the first year is dependent on the availability of
> appropriated funds for MCHR in subsequent years, grantee satisfactory
> performance, and a decision that funding is in the best interest of
> the Federal government.
>
> **Secondary Data Analysis Studies**
>
> The MCH Research Program will provide funding during Federal fiscal
> year 2007. Projects will be awarded for one year.
>
> Subject to the availability of appropriations, approximately \$300,000
> is expected to be available to fund approximately 3 grantees (Ceiling
> amount of an individual award is \$100,000 total cost).

#### III. Eligibility Information

> **1. Eligible Applicants**
>
> As cited in 42 CFR Part 51a.3(b), only public and nonprofit
> institutions of higher learning and public or private nonprofit
> agencies engaged in research or in programs relating to maternal and
> child health and/or services for children with special health care
> needs are eligible. If otherwise eligible, faith-based and community
> organizations are eligible to apply.
>
> **2. Cost Sharing/Matching**
>
> No cost sharing or matching is required for these programs.
>
> **3. Other**
>
> **Other Limitations**

**Extramural Maternal and Child Health Research Program (MCHR)**

> Applications that exceed the ceiling amount (\$300,000 total cost per
> year) will be considered non-responsive and will not be considered for
> funding under this announcement.

**Secondary Data Analysis Studies**

> Applications that exceed the ceiling amount (\$100,000 total cost)
> will be considered non-responsive and will not be considered for
> funding under this announcement.
>
> Any application that fails to satisfy the deadline requirements
> referenced in Section IV.3 will be considered non-responsive and will
> not be considered for funding under this announcement.

#### IV. Application and Submission Information

> **1. Address to Request Application Package**

**Application Materials**

> The application and submission process has changed significantly. HRSA
> is ***requiring*** applicants for this funding opportunity to apply
> electronically through Grants.gov. All applicants ***must*** submit in
> this manner unless the applicant is granted a written exemption from
> this requirement in advance by the Director of HRSA's Division of
> Grants Policy. Grantees must request an exemption in writing from
> <DGPClearances@hrsa.gov>, and provide details as to why they are
> technologically unable to submit electronically though the Grants.gov
> portal. Make sure you specify the announcement number you are seeking
> relief for. As indicated in this guidance, HRSA and its Grants
> Application Center (GAC) will only accept paper applications from
> applicants that received prior written approval.
>
> Refer to Appendix A for detailed application and submission
> instructions. Pay particular attention to Section 3, which provides
> detailed information on the competitive application and submission
> process.
>
> Applicants must submit proposals according to the instructions in
> Appendix A, using this guidance in conjunction with Standard Form 424
> Research and Related (SF-424 R&R). These forms contain additional
> general information and instructions for grant applications, proposal
> narratives, and budgets. These forms may be obtained from the
> following sites by:

[]{.mark}

> \(1\) Downloading from <http://www.hrsa.gov/grants/forms.htm>
>
> Or
>
> \(2\) Contacting the HRSA Grants Application Center at:
>
> The Legin Group, Inc.
>
> 901 Russell Avenue, Suite 450
>
> Gaithersburg, MD 20879
>
> Telephone: 877-477-2123
>
> <HRSAGAC@hrsa.gov>.
>
> Instructions for preparing portions of the application that must
> accompany Standard Form 424 Research and Related (SF-424 R&R) appear
> in the "Application Format" section below.
>
> **2. Content and Form of Application Submission**

**Application Format Requirements**

> See Appendix A, Section 4 for detailed application submission
> instructions. These instructions must be followed.
>
> The total size of all uploaded files **may not exceed the equivalent
> of 80 pages when printed by HRSA, approximately 10 MB. This 80-page
> limit includes the abstract, project and budget narratives,
> attachments, appendices and letters of commitment and support.**
> Standard forms (SF 424 R&R forms) are NOT included in the page limit.
>
> **Applications that exceed the specified limits (approximately 10 MB,
> or that exceed 80 pages when printed by HRSA) will be deemed
> non-compliant. All non-compliant applications will be returned to the
> applicant without further consideration.**

**Application Format**

> Applications for funding must consist of the following documents in
> the following order:

### SF 424 R&R -- Table of Contents

-   It is mandatory to follow the instructions provided in this section
    to ensure that your application can be printed efficiently and
    consistently for review.

-   Failure to follow the instructions may make your application
    non-compliant. Non-compliant applications will not be given any
    consideration and those particular applicants will be notified.

-   For electronic submissions, applicants only have to number the
    electronic attachment pages sequentially, resetting the numbering
    for each attachment, i.e., start at page 1 for each attachment. Do
    not attempt to number standard OMB approved form pages.

-   For electronic submissions no table of contents is required for the
    entire application. HRSA will construct an electronic table of
    contents in the order specified.

-   When providing any electronic attachment with several pages, add
    table of content page specific to the attachment. Such page will not
    be counted towards the page limit.

-   For paper submissions (when allowed), number each section
    sequentially, resetting the page number for each section. i.e.,
    start at page 1 for each section. Do not attempt to number standard
    OMB approved form pages.

-   For paper submissions ensure that the order of the forms and
    attachments is as specified below.

+------------------+------+-----------------------+-------------------+
| **Application    | **   | **Instruction**       | **HRSA/Program    |
| Section**        | Form |                       | Guidelines**      |
|                  | Ty   |                       |                   |
|                  | pe** |                       |                   |
+==================+======+=======================+===================+
| SF-424RR Cover   | Form | Pages 1 & 2 of the    | Not counted in    |
| Page             |      | R&R face page         | the page limit    |
+------------------+------+-----------------------+-------------------+
| Pre-application  | At   | Can be uploaded on    | Not Applicable to |
|                  | tach | page 2 of SF 424      | HRSA; Do not use. |
|                  | ment | (R&R) - Box 20        |                   |
+------------------+------+-----------------------+-------------------+
| HHS 5161         | Form | Also known as PHS     | Not counted in    |
| Checklist        |      | 5161 checklist        | the page limit    |
+------------------+------+-----------------------+-------------------+
| SF-424RR         | Form | Supports 8 structured | Not counted in    |
| Senior/Key       |      | profiles              | the page limit    |
| Person Profile   |      |                       |                   |
|                  |      | (PD + 7 additional)   |                   |
+------------------+------+-----------------------+-------------------+
| Senior Key       | At   | Can be uploaded in    | Counted in the    |
| Personnel        | tach | SF-424RR Senior/Key   | page limit.       |
| Biographical     | ment | Person Profile form.  |                   |
| Sketches         |      | One per each          |                   |
|                  |      | senior/key person.    |                   |
|                  |      | The PD/PI             |                   |
|                  |      | biographical sketch   |                   |
|                  |      | should be the first   |                   |
|                  |      | biographical sketch.  |                   |
|                  |      | Up to 8 allowed       |                   |
+------------------+------+-----------------------+-------------------+
| Senior Key       | At   | Can be uploaded in    | Not Applicable to |
| Personnel        | tach | SF-424RR Senior/Key   | HRSA; Do not use. |
| Current and      | ment | Person Profile form   |                   |
| Pending Support  |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Not counted in    |
| Senior/Key       | tach | SF-424RR Senior/Key   | the page limit    |
| Person Profiles  | ment | Person Profile form.  |                   |
|                  |      | Single document with  |                   |
|                  |      | all additional        |                   |
|                  |      | profiles              |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Counted in the    |
| Senior Key       | tach | the Senior/Key Person | page limit        |
| Personnel        | ment | Profile form. Single  |                   |
| Biographical     |      | document with all     |                   |
| Sketches         |      | additional sketches   |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Not Applicable to |
| Senior Key       | tach | the Senior/Key Person | HRSA; Do not use. |
| Personnel        | ment | Profile form          |                   |
| Current and      |      |                       |                   |
| Pending Support  |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| SF-424RR         | Form | Supports primary and  | Not counted in    |
| Performance Site |      | 7 additional sites in | the page limit    |
| Locations        |      | structured form       |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | Can be uploaded in    | Counted in the    |
| Performance Site | tach | SF-424RR Performance  | page limit        |
| Location(s)      | ment | Site Locations form.  |                   |
|                  |      | Single document with  |                   |
|                  |      | all additional site   |                   |
|                  |      | locations             |                   |
+------------------+------+-----------------------+-------------------+
| Project          | At   | Can be uploaded in    | Required          |
| Summary/Abstract | tach | SF-424RR Other        | attachment.       |
|                  | ment | Project Information   | Counted in the    |
|                  |      | form, Box 6           | page limit. Refer |
|                  |      |                       | guidance for      |
|                  |      |                       | detailed          |
|                  |      |                       | instructions.     |
|                  |      |                       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| Project          | At   | Can be uploaded in    | Required          |
| Narrative        | tach | SF-424RR Other        | attachment.       |
|                  | ment | Project Information   | Counted in the    |
|                  |      | form, Box 7           | page limit. Refer |
|                  |      |                       | guidance for      |
|                  |      |                       | detailed          |
|                  |      |                       | instructions.     |
|                  |      |                       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| SF-424RR Budget  | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section A -- B   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | SF-424RR Budget       | Not counted in    |
| Senior Key       | tach | Period (1-5) -        | the page limit    |
| Persons          | ment | Section A - B, Box 9. |                   |
|                  |      | One for each budget   |                   |
|                  |      | period                |                   |
+------------------+------+-----------------------+-------------------+
| SF-424RR Budget  | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section C -- E   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| Additional       | At   | SF-424RR Budget       | Not counted in    |
| Equipment        | tach | Period (1-5) -        | the page limit    |
|                  | ment | Section C -- E, Box   |                   |
|                  |      | 11. One for each      |                   |
|                  |      | budget period         |                   |
+------------------+------+-----------------------+-------------------+
| SF-424RR Budget  | Form | Supports structured   | Not counted in    |
| Period (1-5) -   |      | budget for up to 5    | the page limit    |
| Section F -- J   |      | periods               |                   |
+------------------+------+-----------------------+-------------------+
| SF-424RR         | Form | Total cumulative      | Not counted in    |
| Cumulative       |      | budget                | the page limit    |
| Budget           |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Budget Narrative | At   | Can be uploaded in    | Required          |
|                  | tach | SF-424RR Budget       | attachment.       |
|                  | ment | Period (1-5) -        | Counted in the    |
|                  |      | Section F - J form,   | page limit. Refer |
|                  |      | Box K. Only one       | guidance for      |
|                  |      | consolidated budget   | detailed          |
|                  |      | justification for the | instructions.     |
|                  |      | project period.       | Provide table of  |
|                  |      |                       | contents specific |
|                  |      |                       | to this document  |
|                  |      |                       | only as the first |
|                  |      |                       | page              |
+------------------+------+-----------------------+-------------------+
| SF-424RR         | Form | Supports up to 10     | Not counted in    |
| Subaward Budget  |      | budget attachments.   | the page limit    |
|                  |      | This form only        |                   |
|                  |      | contains the          |                   |
|                  |      | attachment list       |                   |
+------------------+------+-----------------------+-------------------+
| Subaward Budget  | At   | Can be uploaded in    | Filename should   |
| Attachment 1-10  | tach | SF-424RR Subaward     | be the name of    |
|                  | ment | Budget form, Box 1    | the organization  |
|                  |      | through 10. Extract   | and unique.       |
|                  |      | the form from the     | Counted in the    |
|                  |      | SF-424RR Subaward     | page limit        |
|                  |      | Budget **PureEdge**   |                   |
|                  |      | form and use it for   |                   |
|                  |      | each                  |                   |
|                  |      | consortium            |                   |
|                  |      | /contractual/subaward |                   |
|                  |      | budget as required by |                   |
|                  |      | the program guidance. |                   |
|                  |      | Supports up to 10.    |                   |
+------------------+------+-----------------------+-------------------+
| SF-424B          | Form | Assurances for the    | Not counted in    |
| Assurances for   |      | SF-424 RR package     | the page limit    |
| Non-Construction |      |                       |                   |
| Programs         |      |                       |                   |
+------------------+------+-----------------------+-------------------+
| Other Project    | Form | Allows additional     | Not counted in    |
| Information      |      | information and       | the page limit    |
|                  |      | attachments           |                   |
+------------------+------+-----------------------+-------------------+
| Bibliography &   | At   | Can be uploaded in    | Required. Counted |
| References       | tach | Other Project         | in the page limit |
|                  | ment | Information form, Box |                   |
|                  |      | 8.                    |                   |
+------------------+------+-----------------------+-------------------+
| Facilities &     | At   | Can be uploaded in    | Required. Counted |
| Other Resources  | tach | Other Project         | in the page       |
|                  | ment | Information form, Box | limit.            |
|                  |      | 9.                    |                   |
+------------------+------+-----------------------+-------------------+
| Equipment        | At   | Can be uploaded in    | Required. Counted |
|                  | tach | Other Project         | in the page limit |
|                  | ment | Information form, Box |                   |
|                  |      | 10.                   |                   |
+------------------+------+-----------------------+-------------------+
| Other            | Form | Supports up to 15     | Not counted in    |
| Attachments Form |      | numbered attachments. | the page limit    |
|                  |      | This form only        |                   |
|                  |      | contains the          |                   |
|                  |      | attachment list       |                   |
+------------------+------+-----------------------+-------------------+
| Attachment 1-15  | At   | Can be uploaded in    | Refer to the      |
|                  | tach | Other Attachments     | attachment table  |
|                  | ment | form 1-15             | provided below    |
|                  |      |                       | for **specific**  |
|                  |      |                       | sequence. Counted |
|                  |      |                       | in the page limit |
+------------------+------+-----------------------+-------------------+
| Other            | At   | Can be uploaded in    | Not Applicable to |
| Attachments      | tach | SF-424 RR Other       | HRSA; Do not use  |
|                  | ment | Project Information   |                   |
|                  |      | form, Box 11.         |                   |
|                  |      | Supports multiple     |                   |
+------------------+------+-----------------------+-------------------+

-   To ensure that attachments are organized and printed in a consistent
    manner, follow the order provided below. Note that these
    instructions may vary across programs.

-   Additional supporting documents, if applicable, can be provided
    using the available rows. Do not use the rows assigned to a specific
    purpose in the program guidance.

  -----------------------------------------------------------------------
  **Attachment        **Attachment Description (Program Guidelines)**
  Number**            
  ------------------- ---------------------------------------------------
  Attachment 1        Letters of Agreement. Where several pages are
                      expected in the attachment, include a table of
                      content cover page specific to this attachment.
                      Table of content page will not be counted in the
                      page limit.

  Attachment 2        Key publications or condensed citations with
                      abstracts. Where several pages are expected in the
                      attachment, include a table of content cover page
                      specific to this attachment. Table of content page
                      will not be counted in the page limit.

  Attachment 3        Surveys, questionnaires, data collection
                      instruments, clinical protocols. Where several
                      pages are expected in the attachment, include a
                      table of content cover page specific to this
                      attachment. Table of content page will not be
                      counted in the page limit.

  Attachment 4        Letters of Support. Where several pages are
                      expected in the attachment, include a table of
                      content cover page specific to this attachment.
                      Table of content page will not be counted in the
                      page limit.

  Attachment 5        Others, as applicable.
  -----------------------------------------------------------------------

> **i. *Application Face Page***
>
> Applicants should use Standard Form 424 Research and Related (SF-424
> R&R), provided with the application package. Prepare this page
> according to instructions provided in the Instructions for the SF-424
> R&R (Appendix C). For information pertaining to the Catalog of Federal
> Domestic Assistance, the Catalog of Federal Domestic Assistance Number
> is 93.110.
>
> **DUNS Number**
>
> All applicant organizations are required to have a Data Universal
> Numbering System (DUNS) number in order to apply for a grant from the
> Federal Government. The DUNS number is a unique nine-character
> identification number provided by the commercial company, Dun and
> Bradstreet. There is no charge to obtain a DUNS number. Information
> about obtaining a DUNS number can be found at
> <http://www.hrsa.gov/grants/dunsccr.htm> or call 1-866-705-5711.
> Please include the DUNS number in item 5 on the application face page.
> Application ***will not*** be reviewed without a DUNS number.
>
> Additionally, the applicant organization is required to register with
> the Federal Government's Central Contractor Registry (CCR) in order to
> do electronic business with the Federal Government. Information about
> registering with the CCR can be found at
> <http://www.hrsa.gov/grants/dunsccr.htm>.

**ii. *Table of Contents***

> The application should be presented in the order of the Table of
> Contents provided earlier. Again, for electronic applications no table
> of contents is necessary as it will be generated by the system. (Note:
> the Table of Contents will not be counted in the page limit).

**iii. *Application Checklist***

> Use Standard Form 424 Research and Related (SF-424 R&R) provided with
> the application package.

**iv. *Budget ***

> Use SF-424 R&R Budget pages, provided with the application package.
> Please complete SF-424 R&R Budget pages: Section A&B, Section C, D, &
> E, Section F-K and Cumulative Budget for each project year. NOTE: The
> Cumulative Budget page for each project year will be automatically
> computed. The applicant does not need to calculate the figures for
> this page. Please complete the R& R Subaward Budget Attachment(s) Form
> for each contractual arrangement. These forms will represent the full
> project period of Federal assistance requested. All budgets must be
> well justified, with explanations of each line item. NOTE: Contractual
> costs entered in the R&R Subaward Budget Attachment(s) Form do not
> automatically get included in the Cumulative Budget page for each
> budget period. Therefore, you must include the amount for contractual
> costs in Section F -- K, #5 Subawards/Consortium/Contractual costs of
> each budget period. This will ensure that the cumulative budget page
> for each budget period will correctly reflect the entire cost for each
> budget period.

**v. *Budget Justification***

> Provide a narrative that explains the amounts requested for each line
> in the budget. The budget justification should specifically describe
> how each item will support the achievement of proposed objectives. The
> budget period is for ONE year. However, the applicant must submit
> one-year budgets for each of the subsequent project period years
> (usually one to three years or more) at the time of application. Line
> item information must be provided to explain the costs entered in
> appropriate form, SF-424 R&R. **The budget justification must clearly
> describe each cost element and explain how each cost contributes to
> meeting the project's objectives/goals.** Be very careful about
> showing how each item in the "other" category is justified. The budget
> justification MUST be concise. Do NOT use the justification to expand
> the project narrative.
>
> ***Budget for Multi-Year Grant Award*** (N/A to Secondary Data
> Analysis Studies)
>
> This announcement is inviting applications for project periods up to 4
> years. Awards, on a competitive basis, will be for a one-year budget
> period, although project periods may be for up to four years.
> Applications for continuation grants funded under these awards beyond
> the one-year budget period but within the multi-year project period
> will be entertained in subsequent years on a noncompetitive basis,
> subject to availability of funds, satisfactory progress of the grantee
> and a determination that continued funding would be in the best
> interest of the Government.
>
> ***Caps on Expenses***
>
> **MCH Extramural Research Program**
>
> Applications must not exceed the \$300,000 ceiling amount of an
> individual award. This ceiling includes both direct and indirect
> expenses per year.
>
> **Secondary Data Analysis Studies**
>
> Applications must not exceed the \$100,000 ceiling amount of an
> individual award. This ceiling includes both direct and indirect
> expenses.

[]{.mark}

> Include the following in the Budget Justification narrative:
>
> **Personnel Costs:**
>
> Personnel costs should be explained by listing each staff member who
> will be supported from funds, name (if possible), position title,
> percent full time equivalency, annual salary, and the exact amount
> requested for each project year.
>
> **Indirect Costs:**
>
> Indirect costs are those costs incurred for common or joint objectives
> which cannot be readily identified but are necessary to the operations
> of the organization, e.g., the cost of operating and maintaining
> facilities, depreciation, and administrative salaries. For
> institutions subject to OMB Circular A-21, the term "facilities and
> administration" is used to denote indirect cost. If an organization
> applying for an assistance award does not have an indirect cost rate,
> the applicant may wish to obtain one through HHS's Division of Cost
> Allocation (DCA). Visit DCA's website at: <http://rates.psc.gov/> to
> learn more about rate agreements, the process for applying for them,
> and the regional offices through which they are negotiated.
>
> **Fringe Benefits:**
>
> List the components that comprise the fringe benefit rate, for example
> health insurance, taxes, unemployment insurance, life insurance,
> retirement plan, tuition reimbursement. The fringe benefits should be
> directly proportional to that portion of personnel costs that are
> allocated for the project.
>
> **Travel:**
>
> List travel costs according to local and long distance travel. For
> local travel, the mileage rate, number of miles, reason for travel and
> staff member/consumers completing the travel should be outlined. The
> budget should also reflect the travel expenses associated with
> participating in meetings and other proposed trainings or workshops.
>
> **Equipment:**
>
> List equipment costs and provide justification for the need of the
> equipment to carry out the program's goals. Extensive justification
> and a detailed status of current equipment must be provided when
> requesting funds for the purchase of computers and furniture items.
>
> **Supplies:\
> **List the items that the project will use. In this category, separate
> office supplies from medical and educational purchases. Office
> supplies could include paper, pencils, and the like; medical supplies
> are syringes, blood tubes, plastic gloves, etc.**,** and educational
> supplies may be pamphlets and educational videotapes. Remember, they
> must be listed separately.
>
> **Subcontracts:\
> **To the extent possible, all subcontract budgets and justifications
> should be standardized, and contract budgets should be presented by
> using the same object class categories contained in the Standard Form
> 424A. Provide a clear explanation as to the purpose of each contract,
> how the costs were estimated, and the specific contract deliverables.
> Use the SF 424 R&R Subaward Budget Attachment(s) Form for all
> subcontracts and subcontract budget justifications. Also include
> yearly subcontract costs in the SF424 R&R "Budget -- Section F -- K
> #5. Subawards/Consortium/ Contractual Costs" for each budget period.
> This will ensure that this cost figure will be included in the
> Cumulative Budget page for each budget period.
>
> **Consultant Costs:\
> **Give name and institutional affiliation, qualifications of each
> consultant, if known, and indicate the nature and extent of the
> consultant service to be performed. Include expected rate of
> compensation and total fees, travel, per diem, or other related costs
> for each consultant.
>
> **Other:**
>
> Put all costs that do not fit into any other category into this
> category and provide an explanation of each cost in this category. In
> some cases, grantee rent, utilities and insurance fall under this
> category if they are not included in an approved indirect cost rate.

**vi. Staffing Plan and Personnel Requirements**

> Applicants must present a staffing plan and provide a justification
> for the plan that includes education and experience qualifications and
> rationale for the amount of time being requested for each staff
> position. Position descriptions that include the roles,
> responsibilities, and qualifications of proposed project staff must be
> included in the "Budget Narrative" section that will be uploaded in
> SF-424 R&R Budget Period -- Section F -- J Form, Box K. Copies of
> biographical sketches for any key employed personnel that will be
> assigned to work on the proposed project must also be submitted as an
> attached file to each SF-424 R&R Senior/Key Person Profile. NOTE: Use
> the sample Biosketch Form found in Appendix D. Recommended information
> includes: Education and Training, Research and Professional
> Experience, Collaborators and Affiliations (for conflicts of
> interest), Publications and Synergistic Activities. The Biographical
> Sketch may not exceed four pages per person. This 4-page limit
> includes the table at the top of the first page.
>
> Biographical sketches should follow the format described below.
>
> Complete the educational block at the top of the format page, and
> complete Sections A, B, C and D.

A.  **Positions and Honors.** List in chronological order previous
    positions, concluding with your present position. List any honors.
    Include present membership on any Federal Government public advisory
    committee.

B.  **Selected peer-reviewed publications or manuscripts in press (in
    chronological order).** Do not include manuscripts submitted or in
    preparation.

C.  **Research Support.** List both selected ongoing and completed
    (during the last three years) research projects (Federal or
    non-Federal support). Begin with the projects that are most relevant
    to the research proposed in this application. Briefly indicate the
    overall goals of the projects and responsibilities of the key person
    identified on the Biographical Sketch. **[You must also include
    percent effort on all ongoing research projects
    listed]{.underline}**. The Research Support section highlights your
    accomplishments, and those of your colleagues, as scientists. This
    information will be used by the reviewers in the assessment of each
    individual's qualifications for a specific role in the proposed
    project, as well as to evaluate the overall qualifications of the
    research team.

D.  **Additional Current and Pending Support(s).** Provide a list of all
    current and pending support for the PD/PI and each Senior/Key Person
    (even if they receive no salary support from the project(s)) for
    ongoing projects and pending proposals. Show the total award amount
    for the entire award period (including indirect costs) as well as
    the percent effort to be devoted to the project by the senior/key
    person, regardless of source of support. If the applicant receives
    support for the project at any time prior to receipt of an award or
    postaward by the MCH Research Program, the MCH Research Program must
    be notified.

**vii. Assurances**

> Complete the Assurances -- Non-Construction Programs form included in
> the SF-424 R&R Form application package.
>
> The following are additional assurances pertinent to applying for both
> the **MCHR and SDAS.** Each application requires that the following
> assurances be verified by the signature of the official/representative
> signing for the applicant organization on the face page of the
> application. In signing the application Face Page, the duly authorized
> representative of the applicant organization certifies that the
> applicant organization will comply with the following assurances:
> Human Subjects, Research Using Human Pluripotent Stem Cells, Research
> on Transplantation of Human Fetal Tissue, Women and Minority Inclusion
> Policy, Inclusion of Children Policy.

**viii. Certifications**

> The following are certifications pertinent to applying for both the
> **MCHR and SDAS**. Each application requires that the following
> certifications be verified by the signature of the
> official/representative signing for the applicant organization on the
> face page of the application. In signing the application Face Page,
> the duly authorized representative of the applicant organization
> certifies that the applicant organization will comply with the
> following certifications: Debarment and Suspension, Drug-Free
> Workplace, Lobbying, Non-Delinquency on Federal Debt, Research
> Misconduct, Civil Rights, Handicapped Individuals, Sex Discrimination,
> Age Discrimination, Financial Conflict of Interest.
>
> Complete definitions for the above assurances and certifications are
> provided in the NIH Grants Policy Statement found at:
>
> <http://grants1.nih.gov/grants/policy/nihgps_2003/index.htm>
>
> OR in the U.S. Department of Health and Human Services Grants.gov
> Application Guide for SF 424 R&R found at:
>
> <http://grants1.nih.gov/grants/funding/424/SF424_RR_Guide_General.doc>
> .

**ix. Project Abstract**

> Provide a summary of the application. Because the abstract is often
> distributed to provide information to the public and Congress, please
> prepare this so that it is clear, accurate, concise, and without
> reference to other parts of the application. It must include a brief
> description of the proposed grant project including the needs to be
> addressed, the proposed services, and the population group(s) to be
> served.
>
> Please place the following at the top of the abstract:

-   Project Title

-   Principal Investigator Name

-   Applicant Organization Name

> The project abstract must be single-spaced and limited to one page in
> length. In describing the research design and methods within the
> abstract, be careful to include data collection methods. Select a
> maximum of 8 significant key words from Appendix G: Menu of Suggested
> Key Words that describe the project, including proposed study
> population and include this at the end of your abstract. Briefly state
> the principal needs and problems which are addressed by the project,
> including the project\'s relationship to current MCHB Strategic
> Research Issues (Appendix E). A complete and informative abstract is
> critical to the review of your application.
>
> **x. Program Narrative/Research Plan**
>
> This section provides a comprehensive framework and description of all
> aspects of the proposed program. It should be succinct,
> self-explanatory and well organized so that reviewers can understand
> the proposed project.
>
> Use the following section headers for the Narrative:
>
> **[A. Introduction]{.underline}** (for 2^ND^/3^RD^ submission only):
> The introduction may not exceed **three pages for 2^ND^/3^RD^
> submissions** (previously known as a revised application or amendment)
>
> **NOTE: PLEASE MARK THE APPLICATION AS NEW ON THE SF-424 R&R EVEN IF
> IT HAS PREVIOUSLY BEEN REVIEWED AND IS BEING SUBMITTED A 2^ND^ OR
> 3^RD^ TIME TO ADDRESS REVIEWERS' COMMENTS.**
>
> For a 2^nd^ or 3^rd^ submission of a previously reviewed proposal,
> begin the Introduction by specifying whether it is a 2^nd^ or 3^rd^
> submission; state the application/tracking number of the prior
> submission, its title, and cycle of review. **Example: AThis is a
> second (third) submission of application #, [Determinants of Racial
> Disparities in Infant Mortality Rates]{.underline} that was reviewed
> at the November, 1997 cycle.@** Keep in mind that the function of the
> AIntroduction@ section is to let the reviewers know that the concerns
> raised in the earlier review have been addressed in the current
> proposal, inform them where in the proposal the concerns have been
> addressed, and offer rationales for the changes and additions made.
> The changes in the research plan must be clearly marked by appropriate
> bracketing, indenting, or changing of typography, unless the changes
> are so extensive as to include most of the text.
>
> **[B. Progress Report]{.underline}** for Renewal/Competing
> Continuation Applications. The progress report may not exceed **three
> pages**. A progress report must be provided for renewal/competing
> continuation applications. Provide the beginning and ending dates for
> the period covered since the project was last reviewed competitively.
> Summarize the previous application's specific aims and the importance
> of the findings. Discuss any changes in the specific aims as a result
> of budget reductions. Include the complete references to appropriate
> publications and manuscripts accepted for publication.
>
> If the Renewal/competing continuation application involves clinical
> research, then you must report on the enrollment of research projects
> and their distribution by ethnicity/race and sex/gender.
>
> Provide a succinct account of published and unpublished results,
> indicating progress toward their achievement.
>
> List the titles and complete references to all publications,
> manuscripts accepted for publication, patents, and other printed
> materials that have resulted from the project since it was last
> reviewed competitively. Up to 10 such publications may be included in
> the appendix attachment.
>
> Renewal/competing continuation applications should begin the Progress
> report section by identifying the project by its grant number, title,
> the originally approved project period, and the additional time that
> is being requested. A justification for the extension should follow**.
> Renewal/competing continuation applications pursuing new work should
> keep the title of the original investigation and add to it a ACPhase 2
> or 3, etc.@**
>
> Sections c -- f (specific aims, background and significance,
> preliminary studies/progress report, and research design and methods)
> **[may not exceed 25 pages total]{.underline}**. You may use any page
> distribution within this overall limitation. For Secondary Data
> Analysis studies, these sections **[may not exceed 10 pages
> total]{.underline}**.
>
> **[C. Specific Aims]{.underline}**: List the broad, long-term
> objectives and the goal of the specific research proposed, for
> example, to test a stated hypothesis, create a novel design, solve a
> specific problem, challenge an existing paradigm or clinical practice,
> address a critical barrier to progress in the field, or develop new
> technology.
>
> Write a statement of the research problem, indicate the problem=s
> relevance to maternal and child health or children with special health
> care needs programs and identify the envisioned application of
> findings to the clinical management of mothers and children and/or the
> ways that maternal and child health services are organized and
> delivered. Please identify relevance to MCHB Strategic Research
> Issues, Appendix D.
>
> **Hypothesis and Specification of Variables.** Present the specific
> questions that are to be answered by the study. These should include
> not only predictions as to findings (hypotheses) but also
> justifications for the predictions. A summary table of the variables,
> classified as independent, intervening, mediating, and dependent, etc.
> should be presented, specifying the nature of the variables, the
> measures to be employed as indicators for these variables, and the
> units and levels of measurement of the indicators. If possible,
> construct and present a model or graphical representation of the set
> of relationships held to be operative among the variables. **Make sure
> that there is congruence between the associations depicted by the
> graphic model, the table of variables, the statement of hypotheses,
> and the plan for data analysis.**
>
> **[D. Background and Significance]{.underline}**: Briefly sketch the
> background leading to the present application, critically evaluate
> existing knowledge, and specifically identify the gaps that the
> project is intended to fill. State concisely the importance and health
> relevance of the research described in this application by relating
> the specific aims to the broad, long-term objectives. If the aims of
> the application are achieved, state how specific knowledge or clinical
> practice will be advanced. Describe the effect of these studies on the
> concepts, methods, technologies, treatments, services or preventative
> interventions that drive this field.
>
> **[E. Preliminary Studies]{.underline}**: For new applications, use
> this section to provide an account of the PD/PI's preliminary studies
> pertinent to this application, including his/her preliminary
> experience with and outreach to the proposed racial/ethnic group
> members. This information will also help to establish the experience
> and competence of the investigator to pursue the proposed project.
> Preliminary data often aid the reviewers in assessing the likelihood
> of the success of the proposed project.
>
> **[F. Research Design and Methods]{.underline}**: Describe the
> research design conceptual or clinical framework, procedures, and
> analyses to be used to accomplish the specific aims of the project.
> Unless addressed separately in Item 14, include how the data will be
> collected, analyzed and interpreted as well as the data-sharing plan
> as appropriate. Describe any new methodology and its advantage over
> existing methodologies. Describe any novel concepts, approaches,
> tools, or technologies for the proposed study. Discuss the potential
> difficulties and limitations of the proposed procedures and
> alternative approaches to achieve the aims. As part of this section,
> provide a tentative sequence or timetable for the project. Point out
> any procedures, situations, or materials that may be hazardous to
> personnel and the precautions to be exercised.
>
> **[The Research Plan subsections c -- f (specific aims, background and
> significance, preliminary studies, and research design and methods)
> should not exceed 25 pages total]{.underline}.** For 2^nd^/3^rd^
> submissions only, the Introduction should not exceed 3 pages total.
> The introduction for 2^nd^/3^rd^ submissions is not counted in the 25
> page limit of sections c -- f of the Research Plan. For
> Renewal/competing continuation applications only, the Progress Report
> should not exceed 3 pages total. The progress report is not counted in
> the 25 page limit of sections c -- f of the Research Plan.
>
> **[G. Financing]{.underline}**: State whether this proposal has been
> submitted or will be submitted to any other Federal agency or private
> foundation for consideration and review. Explain the amount of support
> available or expected for this project from other sources.
>
> **NOTE: If there are going to be multiple sources of support, explain
> the amount of support promised or committed by the other prospective
> sources of support in addition to the proportion of overall costs
> being requested from the MCHB Research Program. Offer evidence of
> these sources' commitment and certainty of support. This should give
> the reviewers and the awarding officials of HRSA an idea of how much
> the entire study will cost and what proportion of such overall cost
> the MCH Research Program is being asked to defray.**
>
> **[H. Protection of Human Subjects]{.underline}**: Applicants must
> include information on the protection of human subjects for their
> research. Carefully follow the instructions in the Grants.gov
> Application Guide SF424(R&R), Part II Supplemental Instructions for
> Preparing the Human Subjects Section of the Research Plan. These
> instructions can be found at:
> <http://grants1.nih.gov/grants/funding/424/index.htm> . Click on the
> link for the Grants.gov Application Guide SF424 (R&R).
>
> You need to be aware that the involvement of human subjects in
> non-exempt research must be approved by your IRB prior to award. Some
> human subjects research is exempt from the HHS regulations. OHRP
> guidance states that Exemptions should be independently determined.
> Institutions often designate their IRB to make this determination.
>
> **[I. Targeted/Planned Enrollment Table]{.underline}:** Complete the
> sample Targeted/Planned Enrollment Table (Appendix D).
>
> The "Total Planned Enrollment" means the number of subjects that are
> expected to be enrolled during the entire period of the study and are
> needed to evaluate the research question. The "Total Planned
> Enrollment" will be reported in two ways in the table by: "Ethnic
> Category" and by "Racial Categories."
>
> List any proposed racial/ethnic subpopulations below the table.
>
> **[J. Inclusion Enrollment Report Table (Not applicable to Secondary
> Data Analysis Studies):]{.underline}**
>
> For Renewal/competing continuation applications only, complete the
> sample Inclusion Enrollment Report Table (Appendix D) in addition to
> the sample Targeted/Planned Enrollment Table.
>
> **[K. Dissemination Plan]{.underline}**: Describe plans for
> dissemination of project results. State whether the project results
> are regional or national in scope or if replicable.
>
> **Please note the following requirements related to research
> misconduct:**
>
> **[Research Misconduct]{.underline}**
>
> Each institution that applies for or receives Public Health Service
> (PHS) support for biomedical or behavioral research, research training
> or activities related to that research or research training must
> comply with 42 CFR part 93, Public Health Service Policies on Research
> Misconduct. 

 

> An institution with PHS supported biomedical or behavioral research,
> research training or activities related to that research or research
> training must provide PHS with an assurance of compliance with 42 CFR
> part 93, satisfactory to the Secretary.  PHS funding components may
> authorize funds for biomedical and behavioral research, research
> training, or activities related to that research or research training
> only to institutions that have approved assurances and required
> renewals on file with the Office of Research Integrity (ORI). 

 

> The responsible institutional official must assure on behalf of the
> institution that the institution (1) Has written policies and
> procedures in compliance with part 93 for inquiring into and
> investigating allegations of research misconduct; and (2) Complies
> with its own policies and procedures and the requirements of part 93. 

 

> Research misconduct means fabrication, falsification, or plagiarism in
> proposing, performing, or reviewing research, or in reporting research
> results.
>
> \(a\) Fabrication is making up data or results and recording or
> reporting them.
>
> \(b\) Falsification is manipulating research materials, equipment, or
> processes, or changing or omitting data or results such that the
> research is not accurately represented in the research record.
>
> \(c\) Plagiarism is the appropriation of another person's ideas,
> processes, results, or words without giving appropriate credit.
>
> \(d\) Research misconduct does not include honest error or differences
> of opinion.

 

> For further information, please contact:
>
> U.S. Department of Health and Human Services
>
> Office of Research Integrity
>
> 1101 Wootton Parkway, Suite 750
>
> Rockville, MD  20852
>
> <AskORI@osophs.dhhs.gov>
>
> Phone: (240) 453-8200
>
> Fax: (301) 443-5351
>
> **xi. Attachments**
>
> Please provide the following items to complete the content of the
> application. Please note that these are supplementary in nature, and
> are not intended to be a continuation of the research plan. Be sure
> each attachment is clearly labeled.

1)  Attachment 1: Letters of agreement

> Provide any documents that describe working relationships between the
> applicant agency and other agencies and programs cited in the
> proposal. Documents that confirm actual or pending contractual
> agreements should clearly describe the roles of the subcontractors and
> any deliverable. Letters of agreements must be dated.

2)  Attachment 2: Key Publications or condensed citations with abstracts
    (to meet HRSA page limit requirements).

3)  Attachment 3: Surveys, questionnaires, data collection instruments,
    clinical protocols.

4)  Attachment 4: Letters of Support

> Include only letters of support which specifically indicate a
> commitment to the project/program (in-kind services, dollars, staff,
> space, equipment, etc.) Letters of support must be dated. List all
> other support letters on one page.

**3. Submission Dates and Times**

**Application Due Date**

The due date for applications under this grant announcement is July 24,
2006 at 8:00 P.M. ET. Applications will be considered as meeting the
deadline if they are E marked on or before the due date. Please consult
Appendix A, Section 3 for detailed instructions on submission
requirements.

> The Chief Grants Management Officer (CGMO) or a higher level designee
> may authorize an extension of published deadlines when justified by
> circumstances such as acts of God (e.g. floods or hurricanes),
> widespread disruptions of mail service, or other disruptions of
> services, such as a prolonged blackout. The authorizing official will
> determine the affected geographical area(s).
>
> Applications must be submitted by 8:00 P.M. ET. **To ensure that you
> have adequate time to follow procedures and successfully submit the
> application, we recommend you register immediately in Grants.gov (see
> Appendix B) and complete the forms as soon as possible, as this is a
> new process and may take some time.**
>
> **Please refer to Appendix B for important specific information on
> registering, and Appendix A, Section 3 for important information on
> applying through Grants.gov.**
>
> **Late applications**
>
> Applications which do not meet the criteria above are considered late
> applications. Health Resources and Services Administration (HRSA)
> shall notify each late applicant that its application will not be
> considered in the current competition.

**4. Intergovernmental Review**

Executive Order 12372, "Intergovernmental Review of Federal Programs"
allows States the option of setting up a system for reviewing
applications from within their States for assistance under certain
Federal Programs. Executive Order 12372 is not applicable to the R40
Extramural MCH Research Program or R40 Secondary Data Analysis Studies.

**5. Funding Restrictions**

**Extramural Research Program**

Applicants may request funding for a project period of up to 4 years.
The ceiling amount of an individual award is \$300,000 total cost per
year.

Awards for the first year are subject to the availability of
appropriations. Awards to support projects beyond the first budget year
will be contingent upon Congressional appropriation, satisfactory
progress in meeting the project's objectives, and a determination that
continued funding would be in the best interest of the government.

**Secondary Data Analysis Studies**

Applicants may request funding for a project period of 1 year. The
ceiling amount of an individual award is \$100,000 total cost.

**6. Other Submission Requirements**

> As stated in Section IV.1, except in rare cases HRSA will no longer
> accept applications for grant opportunities in paper form. Applicants
> submitting for this funding opportunity are ***required*** to submit
> ***electronically*** through Grants.gov. To submit an application
> electronically, please use the
> [http://www.Grants.gov](http://www.Grants.gov/) apply site. When using
> Grants.gov you will be able to download a copy of the application
> package, complete it off-line, and then upload and submit the
> application via the Grants.gov site.
>
> As soon as you read this, whether you plan on applying for a HRSA
> grant later this month or later this year, it is incumbent that your
> organization ***immediately register*** in Grants.gov and become
> familiar with the Grants.gov site application process. If you do not
> complete the registration process you will be unable to submit an
> application. The registration process can take up to one month, so you
> need to begin immediately.
>
> To be able to successfully register in Grants.gov, it is necessary
> that you complete all of the following required actions:
>
> • Obtain an organizational Data Universal Number System (DUNS) number
>
> • Register the organization with Central Contractor Registry (CCR)
>
> • Identify the organization's E-Business POC (Point of Contact)
>
> • Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
> password
>
> • Register an Authorized Organization Representative (AOR)
>
> • Obtain a username and password from the Grants.gov Credential
> Provider
>
> Instructions on how to register, tutorials and FAQs are available on
> the Grants.gov web site at [www.grants.gov](http://www.grants.gov/).
> Assistance is also available from the Grants.gov help desk at
> <support@grants.gov> or by phone at 1-800-518-4726.
>
> More specific information, including step-by-step instructions on
> registering and applying, can be found in Appendix B of this guidance.
>
> **Formal submission of the electronic application:** Applications
> completed online are considered formally submitted when the
> Authorizing Official electronically submits the application to HRSA
> through Grants.gov. However, to complete the submission requirements,
> a hard-copy of the SF-424/5161 Face Sheet must be printed, signed, and
> submitted to the HRSA Grants Application Center. The SF-424/5161 must
> be printed from Grants.gov.
>
> For applications submitted electronically, the signed SF-424/5161 must
> be sent to the HRSA GRANTS APPLICATION CENTER at the following address
> and received by HRSA by no later than five days after the date of
> submission in Grants.gov:
>
> The HRSA Grants Application Center
>
> The Legin Group, Inc.
>
> Attn: R40 Extramural MCH Research Program OR R40 Secondary Data
> Analysis Studies
>
> Program Announcement No. HRSA-07-004
>
> CFDA No. 93.110
>
> 901 Russell Avenue, Suite 450
>
> Gaithersburg, MD 20879
>
> Telephone: 877-477-2123
>
> Applications will be considered as having met the deadline if: (1) the
> application has been successfully transmitted electronically by your
> organization's Authorizing Official through Grants.gov on or before
> the deadline date and time, and (2) the signed SF-424/5161 Face Sheet
> is received by HRSA no later than five days after the date of
> submission in Grants.gov.
>
> It is incumbent on applicants to ensure that the AO is available to
> submit the application to HRSA by the application due date. We will
> [not]{.underline} accept submission or re-submission of incomplete,
> rejected, or otherwise delayed applications after the deadline.
>
> Again, please understand that we will not consider additional
> information and/or materials submitted after your initial application.
> You must therefore ensure that all materials are submitted together.

#### V. Application Review Information

**1. Review Criteria**

Procedures for assessing the technical merit of grant applications have
been instituted to provide for an objective review of applications and
to assist the applicant in understanding the standards against which
each application will be judged. Critical indicators have been developed
for each review criterion to assist the applicant in presenting
pertinent information related to that criterion and to provide the
reviewer with a standard for evaluation. Review criteria are outlined
below with specific detail and scoring points.

Review Criteria are used to review and rank applications. The R40
Extramural MCH Research Program and R40 Secondary Data Analysis Studies
have 7 review criteria:

> Criterion 1. [Need]{.underline} (Address MCHB Strategic Research
> Issues) 10 points
>
> Criterion 2. [Response]{.underline} 20 points
>
> Criterion 3. [Evaluative Measures]{.underline} 30 points
>
> Criterion 4. [Impact]{.underline} 10 points
>
> Criterion 5. [Resources/Capabilities]{.underline} 10 points
>
> Criterion 6. [Support Requested]{.underline} 10 points
>
> Criterion 7. [Specific Program Criteria]{.underline} 10 points

TOTAL: 100 points

**Criterion 1: NEED (10 points)**

> The extent to which the application describes an important strategic
> MCH research problem/issue and associated contributing factors, as
> described in the MCHB Strategic Research Issues (Appendix E). The
> Bureau strongly encourages research studies that specifically address
> issues related to MCHB investments and programs, particularly those
> with expected broad public health impact.

-   *Does the Research Project address an MCHB Strategic Research Issue
    (Appendix E) consistent with the MCHB Strategic Plan FYs 2003 -
    2007?\
    *

**Criterion 2: RESPONSE (20 points)**

> The extent to which the proposed project responds to the "Purpose"
> included in the program guidance (pg. 6). The clarity of the proposed
> hypotheses, goals and objectives and their relationship to the
> identified project. The extent to which the scientific activities
> described in the application are capable of addressing the problem and
> attaining the project objectives.

-   Is the overall scientific approach thoughtful, logical and original?

```{=html}
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```
-   What difference will this project make?

-   Does the investigator demonstrate awareness of previous and current
    work in the area of the project? Is the cited literature pertinent
    to the research problem and does it provide a rationale for the
    research?

-   Are the hypotheses logically derived from the literature and clearly
    stated? Are they related to the defined problem?

-   Are the goals and objectives clear, concise and appropriate?

**CRITERION 3: EVALUATIVE MEASURES (30 points)**

> The effectiveness of the methods proposed to conduct the research
> project. Measures must be able to assess to what extent the project
> objectives have been met.
>
> [Scientific and Technical Merit:]{.underline}

-   Are the research plan and methodologies described appropriate?

-   Is the research plan coherent as a whole?

> [Tests and Measurements:]{.underline}

-   Are data gathering procedures described?

-   If new data are to be collected, have instruments been selected or
    developed? Are they adequate and appropriate?

-   Is adequate attention given to reliability and validity
    (psychometric properties)?

-   If secondary analysis of existing data is proposed, are the data
    available to the investigator and are they appropriate for this
    study?

> [Study Design:]{.underline}

-   Is the study design appropriate to answer the research questions?

-   Are proper controls included?

-   Is the description of the design explicit enough to permit
    replication?

-   Have all the significant threats to internal and external validity
    of the design been adequately acknowledged and addressed?

-   Is the method of randomization, if used, clearly described and are
    criteria for entering the study well defined?

> [Population Description and Sampling Plan:]{.underline}

-   Is the study population described?

-   Is the sampling design described? Is it appropriate?

-   Is the sample size adequate and justified in terms of statistical
    power?

-   Are expected differences between groups defined in terms of
    statistical as well as clinical significance?

-   Is there a basis for anticipating the quality of sample estimates
    and is the quality adequate for the purpose of the study?

> [Plan for Data Analysis:]{.underline}

-   Are plans for data analysis presented in detail?

-   Do the plans describe the process of data analysis and the rationale
    for the sequence of steps to be taken?

-   Are plans appropriate to the nature of the data, design and samples?

-   Are statistical methods appropriate?

-   Is sufficient time allocated for data analysis and reporting?

**CRITERION 4: IMPACT (10 points)**

The extent and effectiveness of plans for dissemination of project
results and/or the extent to which project results may be regional or
national in scope and/or degree to which the project activities are
replicable.

-   Is there an effective publication and dissemination plan?

-   Is the problem addressed by the proposed research unique to a
    community or region or is it one of national proportion?

-   Does the applicant convincingly argue for and support contentions of
    regional or national significance?

-   Will the findings be generalizable?

-   Is the number of mothers or children affected by the problem or to
    benefit from the research significant?

**CRITERION 5: RESOURCES/CAPABILITIES (10 points)**

> The extent to which project personnel are qualified by training and/or
> experience to implement and carry out the research project. The
> capabilities of the applicant organization, and quality and
> availability of facilities and personnel to fulfill the needs and
> requirements of the proposed research project.

-   Are the Principal Investigator and staff well qualified by training
    and/or expertise to conduct the research?

-   Does the applicant have the existing resources/facilities to support
    the type of research that they describe in the proposal?

-   Is the organizational and physical environment supportive of the
    investigator and the project?

-   Have the key personnel indicated other current and pending support
    in their biographical sketches?

> **CRITERION 6: SUPPORT REQUESTED (10 points)**
>
> The reasonableness of the proposed budget in relation to the
> objectives, the complexity of the research activities, and the
> anticipated results.

-   The extent to which costs as outlined in the budget and required
    resources sections are reasonable given the scope of work.

-   The extent to which budget line items are well described and
    justified in the budget justification.

-   The extent to which time allocated by key personnel is appropriate
    to achieve project objectives.

-   Does the application address other current and pending support for
    the current project?

**CRITERION 7: SPECIFIC PROGRAM CRITERIA (10 points)**

> [Human Subjects:]{.underline}
>
> The extent to which the proposal adequately addresses human subjects
> protections as appropriate.

-   Are there adequate protections afforded human subjects?

-   Is the proposal in compliance with the Department of Health and
    Human Services (HHS) regulations for protection of human subjects
    (45 CFR Part 46). See the Instructions in the Grants.gov Application
    Guide SF424 (R&R), Part II Supplemental Instructions for Preparing
    the Human Subjects Section of the Research Plan. These instructions
    can be found at:
    <http://grants1.nih.gov/grants/funding/424/index.htm> . Click on the
    link for the Grants.gov Application Guide SF424 (R&R).

-   Does the applicant discuss plans to seek IRB approval?
    (Institutional Review Board (IRB) Approval must be received prior to
    project start date but is not required at the time of application
    submission).

> [Cultural Competency:]{.underline}
>
> The extent to which the proposal assures cultural competence.

-   Does the proposal include individuals from the study population in
    the planning and implementation of the research project?

-   Does the proposal adequately adapt research methodology to reflect
    an understanding of and valuing the culture of the study population?

[Healthy People 2010:]{.underline}

> The extent to which the proposal addresses Healthy People 2010
> objectives.

-   Does the research project identify its relationship to specific
    Healthy People 2010 objectives? (See VI. Award Administration
    Information on Healthy People 2010).

**2. Review and Selection Process**

> The Division of Independent Review is responsible for managing
> objective reviews within HRSA. Applications competing for federal
> funds receive an objective and independent review performed by a
> committee of experts qualified by training and experience in
> particular fields or disciplines related to the program being
> reviewed. In selecting review committee members, other factors in
> addition to training and experience may be considered to improve the
> balance of the committee, e.g., geographic distribution. Each reviewer
> is screened to avoid conflicts of interest and is responsible for
> providing an objective, unbiased evaluation based on the review
> criteria noted above. The committee provides expert advice on the
> merits of each application to program officials responsible for final
> selections for award.
>
> Applications that pass the initial HRSA eligibility screening will be
> reviewed and rated by a panel based on the program elements and review
> criteria presented in relevant sections of this program announcement.
> The review criteria are designed to enable the review panel to assess
> the quality of a proposed project and determine the likelihood of its
> success. The criteria are closely related to each other and are
> considered as a whole in judging the overall quality of an
> application.

**3. Anticipated Announcement and Award Dates**

It is HRSA/MCHB's goal to notify successful applicants at least one
month prior to the project start date (January 1, 2007).

#### VI. Award Administration Information

**1. Award Notices**

Each applicant will receive written notification of the outcome of the
objective review process, including a summary of the expert committee's
assessment of the application's merits and weaknesses, and whether the
application was selected for funding. Applicants who are selected for
funding may be required to respond in a satisfactory manner to
Conditions placed on their application before funding can proceed.
Letters of notification do not provide authorization to begin
performance.

The Notice of Grant Award sets forth amount of funds granted, the terms
and conditions of the grant, the effective date of the grant, the budget
period for which initial support will be given, the non-Federal share to
be provided (if applicable), and the total project period for which
support is contemplated. Signed by the Grants Management Officer, it is
sent to the applicant agency's Authorized Representative, and reflects
the only authorizing document. It will be sent prior to the project
start date of January 1, 2007.

**2. Administrative and National Policy Requirements**

Successful applicants must comply with the administrative requirements
outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92
(governmental), as appropriate.

**PUBLIC POLICY ISSUANCE**

**HEALTHY PEOPLE 2010**

**Healthy People 2010** is a national initiative led by HHS that sets
priorities for all HRSA programs. The initiative has two major goals:
(1) To increase the quality and years of a healthy life; and (2)
Eliminate our country's health disparities. The program consists of 28
focus areas and 467 objectives. HRSA has actively participated in the
work groups of all the focus areas, and is committed to the achievement
of the Healthy People 2010 goals.

Applicants must summarize the relationship of their projects and
identify which of their programs objectives and/or sub-objectives relate
to the goals of the Healthy People 2010 initiative.

Copies of the Healthy People 2010 may be obtained from the
Superintendent of Documents or downloaded at the Healthy People 2010
website: [http://www.health.gov/healthypeople/document]{.underline}/.

**Smoke Free Workplace**

The Public Health Service strongly encourages all award recipients to
provide a smoke-free workplace and to promote the non-use of all tobacco
products. Further, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any portion
of a facility) in which regular or routine education, library, day care,
health care or early childhood development services are provided to
children.

**3. Reporting**

The successful applicant under this guidance must:

1.  Comply with audit requirements of Office of Management and Budget
    (OMB) Circular A-133. Information on the scope, frequency, and other
    aspects of the audits can be found on the Internet at
    [www.whitehouse.gov/omb/circulars](http://www.whitehouse.gov/omb/circulars);

2.  Submit a Payment Management System Quarterly Report. The reports
    identify cash expenditures against the authorized funds for the
    grant. Failure to submit the report may result in the inability to
    access grant funds. Submit report to the:

> Division of Payment Management
>
> DPM/FMS/PSC/ASAM/HHS
>
> PO Box 6021
>
> Rockville, MD 20852
>
> Telephone: (301) 443-1660;
>
> 3\. Submit a Financial Status Report. A financial status report is
> required within 90 days of the end of each grant year. The report is
> an accounting of expenditures under the project that year;
>
> 4\. Submit Progress and Final Reports.
>
> **Extramural MCH Research Program (MCHR)**
>
> Submit an annual Progress Report and Final Report. A publication plan
> should be updated and submitted with the annual progress report. A
> successful applicant under this notice will submit reports in
> accordance with the provisions of the general regulations that apply
> ("Monitoring and Reporting Program Performance" 45 CFR Part 74.51 and
> Part 92.40). The progress report will be included in the continuation
> application each year. This continuation application should be
> reported using SF-424 R&R, which can be accessed at
> <http://www.hrsa.gov/grants/forms.htm> . The continuation application
> is due approximately 90 days before the end of the budget period. All
> projects must submit a final report within 90 days of completing their
> project.
>
> **Secondary Data Analysis Studies (SDAS)**
>
> Submit a Final report at the end of the project period.

**Performance Standards for Special Projects of Regional or National
Significance (SPRANS) and Other MCHB Discretionary Projects**

The Health Resources and Services Administration (HRSA) has modified its
reporting requirements for SPRANS projects, CISS projects, and other
grant programs administered by the Maternal and Child Health Bureau
(MCHB) to include national performance measures that were developed in
accordance with the requirements of the Government Performance and
Results Act (GPRA) of 1993 (Public Law 103-62). This Act requires the
establishment of measurable goals for Federal programs that can be
reported as part of the budgetary process, thus linking funding
decisions with performance. Performance measures for States have also
been established under the Block Grant provisions of Title V of the
Social Security Act, the MCHB's authorizing legislation. Performance
measures for other MCHB-funded grant programs have been approved by the
Office of Management and Budget and are primarily based on existing or
administrative data that projects should easily be able to access or
collect.

**1. Performance Measures and Program Data**

To prepare applicants for these reporting requirements, the designated
performance measures for this program and other program data collection
are presented in Appendix F.

**2. Post-Award Reporting**

Successful applicants receiving grant funds will be required, within 120
days of the Notice of Grant Award (NGA), to register in HRSA's
Electronic Handbooks (EHBs) and electronically complete the program
specific data forms that appear in Appendix F of this guidance.** **
This requires the provision of budget breakdowns in the financial forms
based on the grant award amount, the project abstract and other grant
summary data, and objectives for the performance measures.

#### VII. Agency Contacts

Applicants may obtain additional information regarding business,
administrative, or fiscal issues related to this grant announcement by
contacting:

Jackie Whitaker, Lead Grants Management Specialist

Attn: R40 Extramural MCH Research Program OR R40 Secondary Data Analysis
Studies

HRSA Division of Grants Management Operations, OFAM

Parklawn Building, Room 11A-16

5600 Fishers Lane

Rockville, MD 20857

Telephone: (301) 443-4893

E-mail: [jwhitaker@hrsa.gov](mailto:jking@hrsa.gov)

Additional information related to the overall program issues may be
obtained by contacting:

Rita Haggerty or Hae Young Park

Public Health Analysts, MCH Research Program

Attn: R40 Extramural MCH Research Program OR R40 Secondary Data Analysis
Studies

Maternal and Child Health Bureau, HRSA

Parklawn Building, Room 18A-55

5600 Fishers Lane

Rockville, MD 20857

Telephone: (301) 443-2207; Fax: (301) 443-4842

FAX: (301) 443-4842

E-Mail: <rhaggerty@hrsa.gov> or <hpark@hrsa.gov>

Technical assistance regarding this funding announcement may be obtained
by contacting:

Rita Haggerty or Hae Young Park

Public Health Analysts, MCH Research Program

Attn: R40 Extramural MCH Research Program OR R40 Secondary Data Analysis
Studies

Maternal and Child Health Bureau, HRSA

Parklawn Building, Room 18A-55

5600 Fishers Lane

Rockville, MD 20857

Telephone: (301) 443-2207; Fax: (301) 443-4842

FAX: (301) 443-4842

E-Mail: <rhaggerty@hrsa.gov> or <hpark@hrsa.gov>

#### 

#### VIII. OTHER INFORMATION

Making Websites Accessible: Section 508 of the Rehabilitation Act

<http://www.section508.gov/>

Healthy People 2010

<http://www.health.gov/healthypeople/>

Ten Essential Public Health Core Functions

<http://www.med.jhu.edu/wchpc/pub/Summary-95_.pdf>

Surgeon General's Health Reports

<http://www.surgeongeneral.gov/library/oralhealth/>

Bright Futures

[http://www.brightfutures.aap.org/](http://www.brightfutures.org/)

Cultural Competency

<http://www.georgetown.edu/research/gucdc/nccc/index.html>
<http://www.aap.org/policy/re9753.html>
<http://www.bphc.hrsa.gov/culturalcompetence/Default.htm>

Medical Home

[http://www.aap.org](http://www.aap.org/)

Institute of Medicine

[www.nap.edu](http://www.nap.edu/)

Human Subjects Assurances

[http://ohrp.osophs.dhhs.gov](http://ohrp.osophs.dhhs.gov/)

<http://ohrp.osophs.dhhs.gov/humansubjects/guidance/decisioncharts.htm>

Standards for collecting and reporting data on race and ethnicity

OMB Directive no.15

[www.whitehouse.gov/omb/fedreg/ombdir15.html](http://www.whitehouse.gov/omb/fedreg/ombdir15.html)

Inclusion of children

<http://grants.nih.gov/grants/funding/children/children.htm>

#### ix. Tips for Writing a Strong Application

[]{.mark}

**Include DUNS Number.** You must include A DUNS Number to have your
application reviewed. Application ***will not*** be reviewed without a
DUNS number. To obtain a DUNS number, access
[www.dunandbradstreet.com](http://www.dunandbradstreet.com/) or call
1-866-705-5711. Please include the DUNS number in the appropriate space
on the application face page.

**Keep your audience in mind.** Reviewers will use only the information
contained in the application to assess the application. Be sure the
application and responses to the program requirements and expectations
are complete and clearly written. Do not assume that reviewers are
familiar with the applicant organization. Keep the review criteria in
mind when writing the application.

**Start preparing the application early.** Allow plenty of time to
gather required information from various sources.

**Follow the instructions in this guidance carefully.** Place all
information in the order requested in the guidance. If the information
is not placed in the requested order, you may receive a lower score.

**Be brief, concise, and clear.** Make your points understandable.
Provide accurate and honest information, including candid accounts of
problems and realistic plans to address them. If any required
information or data is omitted, explain why. Make sure the information
provided in each table, chart, attachment, etc., is consistent with the
proposal narrative and information in other tables.

**Be organized and logical.** Many applications fail to receive high
score because the reviewers cannot follow the thought process of the
applicant or because parts of the application do not fit together.

**Be careful in the use of appendices.** Do not use the appendices for
information that is required in the body of the application. Be sure to
cross-reference all tables and attachments located in the appendices to
the appropriate text in the application.

**Carefully proofread the application.** Misspellings and grammatical
errors will impede reviewers in understanding the application. Be sure
pages are numbered (including appendices) and that page limits are
followed. Limit the use of abbreviations and acronyms, and define each
one at its first use and periodically throughout application. Make sure
you submit your application in final form, without markups.

**Ensure that all information is submitted at the same time**. We will
not consider additional information and/or materials submitted after
your initial submission, nor will we accept e-mailed applications or
supplemental materials once your application has been accepted.

APPENDIX A: HRSA's Electronic Submission User Guide

User Guide Table of Contents

1\. INTRODUCTION

1.1. DOCUMENT PURPOSE AND SCOPE

1.2. DOCUMENT ORGANIZATION AND VERSION CONTROL

2\. NONCOMPETING CONTINUATION APPLICATION

2.1. PROCESS OVERVIEW

2.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
[GRANTS.GOV]{.underline}

(IF NOT ALREADY REGISTERED)

2.3. PROJECT DIRECTOR AND AUTHORIZING OFFICIAL NEED TO REGISTER WITH
HRSA EHBs (IF NOT ALREADY REGISTERED)

2.4. APPLY THROUGH [GRANTS.GOV]{.underline}

2.4.1. Find Funding Opportunity

2.4.2. Download Application Package

2.4.3. Complete Application

2.4.4. Submit Application

2.4.5. Verify Status of Application

2.5. VERIFY IN HRSA ELECTRONIC HANDBOOKS

2.5.1. Verify Status of Application

2.5.2. Manage Access to Your Application

2.5.3. Check Validation Errors

2.5.4. Fix Errors and Complete Application

2.5.5. Submit Application

2.6. SUBMIT SIGNED FACE PAGE

3\. COMPETING APPLICATION

3.1. PROCESS OVERVIEW

3.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
[GRANTS.GOV]{.underline}

(IF NOT ALREADY REGISTERED) -- See Appendix B

3.3. APPLY THROUGH [GRANTS.GOV]{.underline}

3.3.1. Find Funding Opportunity

3.3.2. Download Application Package

3.3.3. Complete Application

3.3.4. Submit Application

3.3.5. Verify Status of Application

3.4. SUBMIT SIGNED FACE PAGE

4\. GENERAL INSTRUCTIONS FOR APPLICATION SUBMISSION

4.1. NARRATIVE ATTACHMENT GUIDELINES

4.1.1 Font

4.1.2 Paper Size and Margins

4.1.3 Names

4.1.4 Section Headings

4.1.5 Page Numbering

4.1.6 Allowable Attachment or Document Types

4.2. APPLICATION CONTENT ORDER (TABLE OF CONTENTS)

4.3. PAGE LIMIT

5.0. CUSTOMER SUPPORT INFORMATION

5.1.1 Grants.gov Customer Support

5.1.2 HRSA Call Center

5.1.3 HRSA Program Support

6.0. FAQs

6.1. SOFTWARE

6.1.1. What are the software requirements for using Grants.gov?

6.1.2. Why Can't I download PureEdge Viewer onto my machine?

6.1.3 I have heard that Grants.gov is not Macintosh compatible. What do
I do if I

use only a Macintosh

6.1.4. What are the software requirements for HRSA EHBs?

6.1.5. What are the system requirements for using HRSA EHBs on a
Macintosh

computer?

6.2. APPLICATION RECEIPT

6.2.1. What will be the receipt date -- the date the application is
stamped as received by Grants.gov or the date the data is received by
HRSA?

6.2.2. When do I need to submit my application?

6.2.3. What emails can I expect once I submit my application? Is email
reliable?

6.2.4. If a resubmission is required because of Grants.gov system
problems, will

these be considered "late?"

6.3. APPLICATION SUBMISSION

6.3.1. How can I make sure that my electronic application is presented
in the right

order for objective review?

6.4. GRANTS.GOV HELP

## 1. Introduction

## 1.1 Document Purpose and Scope {#document-purpose-and-scope .unnumbered}

Major changes are coming to HRSA's Grant Application Process. For
guidances released/posted on or after January 1, 2006, HRSA will no
longer accept applications for grant opportunities on paper. Applicants
submitting new and competing continuations and a selected number of
noncompeting continuation applications will be required to submit
electronically through Grants.gov. All applicants must submit in this
manner unless the applicant is granted a written exemption from this
requirement in advance by the Director of HRSA's Division of Grants
Policy.

The purpose of this document is to provide detailed instructions to help
applicants and grantees submit applications electronically to HRSA
through Grants.gov. The document is intended to be the comprehensive
source of all information related to the new processes that HRSA and its
customers have to adopt and will be updated periodically. This document
is not meant to replace program guidance documents for funding
announcements.

## 1.2 Document Organization and Version Control {#document-organization-and-version-control .unnumbered}

This document contains 5 sections apart from the Introduction. Following
is the summary:

  ------------------------------ ----------------------------------------
  **Section**                    **Description**

  Noncompeting Continuation      Provides detailed instructions to
  Application                    existing HRSA grantees for applying
                                 electronically using Grants.gov for all
                                 noncompeting announcements

  Competing Application          Provides detailed instructions to
                                 applicant organizations for applying
                                 electronically using Grants.gov for all
                                 competing announcements

  General Instructions for       Provides instructions and important
  Application Submission         policy guidance on application format
                                 requirements

  Customer Support Information   Provides contact information to address
                                 technical and programmatic questions

  Frequently Asked Questions     Provides answers to frequently asked
  (FAQs)                         questions by various categories
  ------------------------------ ----------------------------------------

This document is under version control. Please visit
<http://www.hrsa.gov/grants> to retrieve the latest published version.

## 2. Noncompeting Continuation Application

## 2.1 Process Overview {#process-overview .unnumbered}

Following is the process for submitting a noncompeting continuation
application through Grants.gov:

a.  HRSA will communicate noncompeting announcement number to the
    project director (PD) and authorizing official (AO) via email. The
    announcement number will be required to search for the announcement
    in Grants.gov.

b.  Search for the announcement in Grants.gov Apply
    (<http://www.grants.gov/Apply>).

c.  Download the application package and instructions from Grants.gov.
    The program guidance is also part of the instructions that must be
    downloaded.

d.  Save a local copy of the application package on your computer and
    complete all the forms based on the instructions provided in the
    program guidance.

e.  Submit the application package through Grants.gov. (Requires
    registration)

f.  Track the status of your submitted application at Grants.gov until
    you receive a notification from Grants.gov that your application has
    been received by HRSA.

g.  HRSA Electronic Handbooks (EHBs) software pulls the application
    information into EHBs and validates the data against HRSA's business
    rules.

h.  HRSA notifies the project director, authorizing official, business
    official (BO) and application point of contact (POC) by email to
    check HRSA EHBs for results of HRSA validations and enter additional
    information, including in some cases performance measures, necessary
    to process the noncompeting continuation.

i.  AO verifies the application in HRSA EHBs, fixes any validation
    errors, makes necessary corrections and submits the application to
    HRSA. (Requires registration)

j.  AO prints the application face page from HRSA EHBs (not Grants.gov),
    signs it and mails it to HRSA's Grant Application Center (GAC).

k.  HRSA receives the signed face page and scans it into the system
    saving it with the electronic application.

## 2.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

1.  Obtain an organizational Data Universal Number System (DUNS) number

2.  Register the organization with Central Contractor Registry (CCR)

3.  Identify the organization's E-Business POC (Point of Contact)

4.  Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
    password

5.  Register an Authorized Organization Representative (AOR)

    -   Obtain a username and password from the Grants.gov Credential
        Provider

    -   Register the username and password with Grants.gov

    -   Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

-   It is recommended that this registration process be completed at
    least two weeks prior to the submittal date of your organization's
    first Grants.gov submission.

##  {#section-1 .unnumbered}

## 2.3 Project Director and Authorizing Official Need to Register with HRSA EHBs (if not already registered) {#project-director-and-authorizing-official-need-to-register-with-hrsa-ehbs-if-not-already-registered .unnumbered}

In order to access your noncompeting continuation application in HRSA
EHBs, existing grantee organizations must register within the EHBs. The
purpose of the registration process is to collect consistent information
from all users, avoid collection of redundant information and allow for
the unique identification of each system user. Note that registration
within HRSA EHBs is required only **once for each user for each
organization they represent.**

Registration within HRSA EHBs is a two-step process. In the first step,
individual users from an organization who participate in the grants
process such as applying for noncompeting continuations must create
**individual** system accounts. In the second step, the users must
associate themselves with the appropriate grantee organization. **To
find your organization record use the 10-digit grant number from the
Notice of Grant Award (NGA) belonging to your grant.** Note that since
all existing grantee organization records already exist within EHBs,
there is no need to create a new one.

To complete the registration quickly and efficiently we recommend that
you have the following information handy:

1.  Identify your role in the grants management process. HRSA EHBs offer
    the following three functional roles for individuals from
    applicant/grantee organizations:

-   Authorizing Official (AO),

-   Business Official (BO), and

-   Other Employee (for project directors, assistant staff, AO designees
    and others).

For more information on functional responsibilities refer to the HRSA
EHBs online help.

2.  10-digit grant number from the latest NGA belonging to your grant
    (Box 4b on NGA). You must use the grant number to find your
    organization during registration. All individuals from the
    organization working on the grant must use the same grant number to
    ensure correct registration.

In order to access the noncompeting application, the project director
and other participants have to register the specific grant and add it to
their respective portfolios. This step is required to ensure that only
the authorized individuals from the organization have access to grant
data. **Project directors will need the last released NGA in order to
complete this additional step**. Again, note that this is a one time
requirement.

The project director must give the necessary privileges to the
authorizing official and other individuals who will assist in the
noncompeting continuation application submission using the administer
feature in the grant handbook. The project director should also delegate
the "Administer Grant Users" privilege to the authorizing official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

Note that registration with HRSA EHBs is independent of Grants.gov
registration.

For assistance in registering with HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   You must use your 10-digit grant number (box 4b from NGA) to
    identify your organization.

## 2.4 Apply through Grants.gov {#apply-through-grants.gov .unnumbered}

### 2.4.1 Find Funding Opportunity {#find-funding-opportunity .unnumbered}

Search for the announcement in Grants.gov **Apply**
(<http://www.grants.gov/Apply>).

Enter the announcement number communicated to you in the field *Funding
Opportunity Number*. (Example announcement number: 5-S45-06-001)

-   Noncompeting announcements are not available in Grants.gov FIND!

### 2.4.2 Download Application Package {#download-application-package .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 2.4.3 Complete Application {#complete-application .unnumbered}

Complete the application using both the built-in instructions and the
instructions provided in the program guidance. Ensure that you save a
copy of the application on your local computer.

-   Ensure that you provide your 10-digit grant number (box 4b from NGA)
    in the Federal Award Identifier field (box 5b in SF424 or box 4 in
    SF424 R&R)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 2.4.4 Submit Application {#submit-application .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you are ready to send your completed application to
Grants.gov.

Review the provided application summary to confirm that the application
will be submitted to the program you wish to apply for. To submit, you
will be asked to Log into Grants.gov. Once you have logged in, your
application package will automatically be uploaded to Grants.gov. A
confirmation screen will appear once the upload is complete. Note that a
Grants.gov Tracking number will be provided on this screen. Please
record this number so that you may refer to it for all subsequent help.

Please direct questions regarding application submission to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 2.4.5 Verify Status of Application {#verify-status-of-application .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two emails. The
first will confirm receipt of your application by the Grants.gov system
("Received"), and the second will indicate that the application has
either been successfully validated ("Validated") by the system prior to
transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional email from
Grants.gov. Subsequently within two to three business days the status
will change to "Agency Tracking Number Assigned."

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

## 2.5 Verify in HRSA Electronic Handbooks {#verify-in-hrsa-electronic-handbooks .unnumbered}

For assistance in registering with or using HRSA EHBs, call 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>.

-   Grant Project Director must be registered in HRSA EHBs and have
    access to the specific grant for which the noncompeting application
    is being submitted for further actions.

### 2.5.1 Verify Status of Application {#verify-status-of-application-1 .unnumbered}

Once your application is received by HRSA, it will be processed to
ensure that the application is submitted for the correct funding
announcement, with the correct grant number and grantee organization.
Upon this processing, which is expected to take up to two to three
business days, HRSA will assign a unique tracking number to your
application. This tracking number will be posted to Grants.gov and the
status of your application will be changed to "Agency Tracking Number
Assigned". Note the HRSA tracking number and use it for all
correspondence with HRSA. At this point, your application is ready for
review and submission in HRSA EHBs.

You should also receive an email from HRSA EHBs confirming the
successful receipt of your application at HRSA. The email is sent to the
project director, authorizing official, point of contact for the
application and the business official -- all from the submitted
application. The email is also sent to the current project director
listed on the NGA. Because email is not always reliable, please check
the HRSA EHBs or Grants.gov to see if the application is available for
review in HRSA EHBs.

-   Because email is not reliable, check HRSA EHBs within two to three
    business days from submission within Grants.gov for availability of
    your application.

### 2.5.2 Manage Access to Your Application {#manage-access-to-your-application .unnumbered}

You must be registered in HRSA EHBs to get access to your application.
To ensure that only the right individuals from the organization get
access to the application, you must follow the process described
earlier.

The project director, using the Administer feature in the grant
handbook, must give the necessary privileges to the authorizing official
and other individuals who will assist in the submission of the
noncompeting continuation application. Project directors must also
delegate the "Administer Grant Users" privilege to the authorizing
official so that future administration can be managed by the authorizing
official.

Once you have access to your grant handbook, use the "Noncompeting
Continuations" link under the deliverables section to access your
noncompeting application.

###  {#section-2 .unnumbered}

### 2.5.3 Check Validation Errors {#check-validation-errors .unnumbered}

HRSA EHBs will apply HRSA's business rules to the application received
through Grants.gov. All validation errors are recorded and displayed to
the applicant. To view the validation errors use the 'Grants.gov Data
Validation Comments' link on the application status page in HRSA EHBs.

### 2.5.4 Fix Errors and Complete Application {#fix-errors-and-complete-application .unnumbered}

Applicants must review the errors in HRSA EHBs and make necessary
changes. Applicants must also complete the detailed budget and other
required forms in HRSA EHBs and assign an AO registered in HRSA EHBs to
the application. HRSA EHBs will show the status of each form in the
application package and all forms must be complete before submission.

### 2.5.5 Submit Application {#submit-application-1 .unnumbered}

To submit an application, you must have the 'Submit Noncompeting
Continuation' privilege. This privilege must be given by the project
director to the authorizing official or a designee. Once all forms are
complete, the application can be submitted to HRSA.

-   You will have two weeks from the date the application was due in
    Grants.gov for submission of the remaining information in HRSA EHBs.
    The new due date will be listed in HRSA EHBs.

## 2.6 Submit Signed Face Page {#submit-signed-face-page .unnumbered}

After successful submission, the AO must print the face page of the
application from the HRSA EHBs, sign it and mail it to HRSA at the
address listed below:

HRSA Grants Application Center

Reference: Announcement Number: *\<Provide HRSA Announcement Number\>*

Reference: Grants.gov Tracking Number: *\<Provide Your Grants.gov
Tracking Number\>*

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

The face page must be received by HRSA within **5** business days from
the date of submission in HRSA EHBs.

Once your signed face page is received by HRSA and saved with the
application, you will receive an email receipt of application from HRSA.

-   Face page must be printed from HRSA EHBs and not from Grants.gov
    application.

## 3. Competing Application

## 3.1 Process Overview {#process-overview-1 .unnumbered}

Following is the process for submitting a competing application through
Grants.gov:

1\. HRSA will post all competing announcements on Grants.gov FIND
(<http://grants.gov/search/>). Announcements are typically posted at the
beginning of the fiscal year when HRSA releases its annual Preview,
although program guidances are generally not available until later. For
more information visit <http://www.hrsa.gov/grants>.

2\. When program guidance is available, search for the announcement in
Grants.gov Apply (<http://www.grants.gov/Apply>).

3\. Download the application package and instructions from Grants.gov.
The program guidance is also part of the instructions that must be
downloaded.

4\. Save a local copy of the application package on your computer and
complete all the forms based on the instructions provided in the program
guidance.

5\. Submit the application package through Grants.gov. (Requires
registration)

6\. Track the status of your submitted application at Grants.gov until
you receive a notification from Grants.gov that your application has
been received by HRSA.

7\. AO prints the application face page from the local copy, signs it
and mails it to HRSA's Grant Application Center (GAC).

8\. HRSA receives the signed face page and scans it into the system
saving it with the electronic application.

## 3.2 Grantee Organization Needs to Register With Grants.gov (if not already registered) -- See Appendix B {#grantee-organization-needs-to-register-with-grants.gov-if-not-already-registered-see-appendix-b-1 .unnumbered}

Grants.gov requires a **one-time** registration by the applicant
organization. This is a three step process and should be completed by
any organization wishing to apply for grant. If you do not complete this
registration process you will not be able to submit an application. The
registration process will require some time (anywhere from 5 business
days to a month). Therefore, applicants or those considering applying at
some point in the future should register immediately. Registration with
Grants.gov provides the individuals from the organization the required
credentials in order to apply.

If an applicant organization has already completed Grants.gov
registration for another Federal agency, this section can be skipped.

For those applicant organizations still needing to register with
Grants.gov, registration information can be found on the Grants.gov Get
Started website (<http://www.grants.gov/GetStarted>). To be able to
successfully register in Grants.gov, it is necessary that you complete
all of the following required actions:

-   Obtain an organizational Data Universal Number System (DUNS) number

-   Register the organization with Central Contractor Registry (CCR)

-   Identify the organization's E-Business POC (Point of Contact)

-   Confirm the organization's CCR "Marketing Partner ID Number (M-PIN)"
    password

-   Register an Authorized Organization Representative (AOR)

```{=html}
<!-- -->
```
-   Obtain a username and password from the Grants.gov Credential
    Provider

-   Register the username and password with Grants.gov

-   Get authorized as an AOR by your organization

In addition, if an applicant does not have a Taxpayer Identification
Number (TIN) or Employer Identification Number (EIN), allow for extra
time. Beginning Oct. 30, 2005, the CCR also validates the EIN against
Internal Revenue Service records, a step that will take one to two
business days.

Please direct questions regarding Grants.gov registration to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

-   It is recommended that this registration process be completed at
    least two weeks prior to the submittal date of your organization's
    first Grants.gov submission.

## 3.3 Apply through Grants.gov {#apply-through-grants.gov-1 .unnumbered}

### 3.3.1 Find Funding Opportunity {#find-funding-opportunity-1 .unnumbered}

Search for announcements in Grants.gov **FIND**
(<http://grants.gov/search/>) and select the announcement that you wish
to apply for. Refer to the program guidance for eligibility criteria.

Please visit <http://www.hrsa.gov/grants> to read annual HRSA Preview.

-   All competing announcements should be available in Grants.gov FIND!
    When program guidance is release, announcements are made available
    in Grants.gov APPLY.

### 3.3.2 Download Application Package {#download-application-package-1 .unnumbered}

Download the application package and instructions. In order to view
application package and instructions, you will also need to download and
install the PureEdge Viewer (<http://www.grants.gov/DownloadViewer>).
This small, free program will allow you to access, complete, and submit
applications electronically and securely.

-   Please review the system requirements for PureEdge Viewer on the
    Grants.gov website.

### 3.3.3 Complete Application {#complete-application-1 .unnumbered}

Complete the application using both the built-in instructions and the
instructions provided in the program guidance. Ensure that you save a
copy of the application on your local computer.

-   If you are applying for a competing continuation or a supplemental
    grant, ensure that you provide your 10-digit grant number (box 4b
    from NGA) in the Federal Award Identifier field (box 5b in SF424 or
    box 4 in SF424 R&R)

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance.

-   You can complete the application offline -- you do not have to be
    connected to the Internet.

### 3.3.4 Submit Application {#submit-application-2 .unnumbered}

The \"Submit\" button on the application package cover page will become
active after you have downloaded the application package, completed all
required forms, attached all required documents, and saved your
application package. Click on the \"Submit\" button once you have done
all these things and you are ready to send your completed application to
Grants.gov.

Review the provided application summary to confirm that the application
will be submitted to the program you wish to apply for. To submit, you
will be asked to Log into Grants.gov. Once you have logged in, your
application package will automatically be uploaded to Grants.gov. A
confirmation screen will appear once the upload is complete. Note that a
Grants.gov Tracking number will be provided on this screen. Please
record this number so that you may refer to it for all subsequent help.

Please direct questions regarding application submission to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

-   You must be connected to the Internet and must have a Grants.gov
    username and password to submit the application package.

### 3.3.5 Verify Status of Application {#verify-status-of-application-2 .unnumbered}

Once Grants.gov has received your submission, Grants.gov will send email
messages to advise you of the progress of your application through the
system. Over the next 24 to 48 hours, you should receive two emails. The
first will confirm receipt of your application by the Grants.gov system
("Received"), and the second will indicate that the application has
either been successfully validated ("Validated") by the system prior to
transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the Director of the Division of Grants Policy**
via email at <DGPClearances@hrsa.gov> and thoroughly explain the
situation; include a copy of the "Rejected with Errors" notification.

You can check the status of your application(s) anytime after
submission, by logging into Grants.gov using the black \'Applicants\'
link at the top of any page, and clicking on the \'Check Application
Status\' link.

If there are no errors, the application will be downloaded by HRSA. On
successful download at HRSA, the status of the application will change
to "Received by Agency" and you will receive an additional email from
Grants.gov.

Once your application is received by HRSA, it will be processed to
ensure that the application is submitted for the correct funding
announcement, with the correct grant number (if applicable), and
applicant/grantee organization. Upon this processing, which is expected
to take up to two to three business days, HRSA will assign a unique
tracking number to your application. This tracking number will be posted
to the Grants.gov and the status of your application will be changed to
"Agency Tracking Number Assigned". Note the HRSA tracking number and use
it for all correspondence with HRSA.

-   It is recommended that you check the status of your application in
    Grants.gov until the status is changed to "Agency Tracking Number
    Assigned".

## 3.4 Submit Signed Face Page {#submit-signed-face-page-1 .unnumbered}

After successful submission in Grants.gov, the AO must print the face
page of the application from Grants.gov, write the Grants.gov Tracking
Number in Federal Award Identifier field (box 5b in SF424 or box 4 in
SF424 R&R), sign it and mail it to HRSA at the address listed below:

HRSA Grants Application Center

Reference: Announcement Number: *\<Provide HRSA Announcement Number\>*

Reference: Grants.gov Tracking Number: *\<Provide Your Grants.gov
Tracking Number\>*

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

The face page must be received by HRSA within **5** business days from
the date of submission in Grants.gov.

Once your signed face page is received by HRSA and saved with the
application, you will receive an email receipt of application from HRSA.

## 4. General Instructions for Application Submission

-   It is mandatory to follow the instructions provided in this section
    to ensure that your application can be printed efficiently and
    consistently for review.

-   

-   Failure to follow the instructions may make your application
    non-compliant. Non-compliant applications will not be given any
    consideration and the particular applicants will be notified.

## 4.1 Narrative Attachment Guidelines {#narrative-attachment-guidelines .unnumbered}

-   The following guidelines are applicable to both electronic and paper
    submissions (when allowed) unless otherwise noted.

### 4.1.1 Font  {#font .unnumbered}

Please use an easily readable serif typeface, such as Times Roman,
Courier, or CG Times. The text and table portions of the application
must be submitted in not less than 12 point and 1.0 line spacing.
Applications not adhering to 12 point font requirements may be returned.
Do not use colored, oversized or folded materials. For

charts, graphs, footnotes, and budget tables, applicants may use a
different pitch or size font, not less than 10 pitch or size font.
However, it is vital that when scanned and/or reproduced, the charts are
still clear and readable.

Please do not include organizational brochures or other promotional
materials, slides, films, clips, etc. 

###  {#section-3 .unnumbered}

### 4.1.2 Paper Size and Margins {#paper-size-and-margins .unnumbered}

For duplication and scanning purposes, please ensure that the
application can be printed on 8 ½" x 11" white paper. Margins must be at
least one (1) inch at the top, bottom, left and right of the paper.
Please left-align text.

### 4.1.3 Names {#names .unnumbered}

Please include the name of the applicant and 10-digit grant number (if
competing continuation, supplemental or noncompeting continuation) on
each page.

### 4.1.4 Section Headings {#section-headings .unnumbered}

Please put all section headings flush left in bold type.

### 4.1.5 Page Numbering {#page-numbering .unnumbered}

**Electronic Submissions**

For electronic submissions, applicants only have to number the
electronic attachment pages sequentially, resetting the numbering for
each attachment, i.e., start at page 1 for each attachment.

Do not number the standard OMB approved form pages.

**Paper Submissions (When allowed)**

Do not number the standard OMB approved forms. Please number each
attachment page sequentially. Reset the numbering for each attachment.
(Treat each attachment/document as a separate section.)

### 4.1.6 Allowable Attachment or Document Types {#allowable-attachment-or-document-types .unnumbered}

**Electronic Submissions**

The following attachment types are supported in HRSA EHBs. Even though
grants.gov may allow you to upload any type of attachment, it is
important to note that HRSA only accepts the following types of
attachments:

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

.XFD -- PureEdge Form

## 4.2 Application Content Order (Table of Contents) {#application-content-order-table-of-contents .unnumbered}

When applications were submitted in paper, it was easy to direct the
applicants to prepare a table of contents and make it as a part of the
application. Applicants did not have any problem in preparing the
package that included standard forms as well as attachments. All the
pages were numbered sequentially. Preparation instructions were given in
the program guidance. With the transition to electronic application
receipt, this process has changed significantly. HRSA is using an
approach that will ensure that regardless of the mode of submission
(electronic or paper when exemptions are granted), all applications will
look the same when printed for objective review.

HRSA uses two standard packages from Grants.gov.

SF 424 (otherwise known as 5161) -- For service delivery programs

SF 424 R&R -- For research and training programs (programs previously
using the 398 or the 6025 and 2590 application packages)

For each package HRSA has defined a standard order of forms and that
order is available within the program guidance. The program guidance may
also provide applicants with explicit instructions on where to upload
specific documents.

If you are applying on paper (when allowed), you must use the program
guidance for the order of the forms and all other applicable guidelines.

## 4.3 Page Limit {#page-limit .unnumbered}

HRSA prints your application for review regardless of whether it is
submitted electronically or by paper (when allowed).

When your application is printed, the narrative documents may not exceed
80 pages in length unless otherwise stated in the program guidance.
These narrative documents include the abstract, project and budget
narratives, and any other attachments such as appendices, letters of
support required as a part of the guidance. This 80 page limit does not
include the OMB approved forms. Note that some program guidances may
require submission of OMB approved program specific forms as
attachments. These attachments will not be included in the 80 page
limit.

Applicants must follow the instructions provided in this section and
ensure that they print out all attachments on paper and count the number
of pages before submission.

-   Applications, whether submitted electronically or on paper, that
    exceed the specified limits will be deemed non-compliant.
    Non-compliant competing applications will not be given any
    consideration and the particular applicants will be notified.
    Non-compliant noncompeting applications will have to be resubmitted
    to comply with the page limits.

## 5. Customer Support Information

### 5.1.1 Grants.gov Customer Support {#grants.gov-customer-support .unnumbered}

Please direct ALL questions regarding Grants.gov to Grants.gov Contact
Center at Tel.: 1-800-518-4726. Contact Center hours of operation are
Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time.

Please visit the following support URL for additional material on
Grants.gov website.

<http://www.grants.gov/CustomerSupport>

### 5.1.2 HRSA Call Center {#hrsa-call-center .unnumbered}

For assistance with or using HRSA EHBs, call 877-GO4-HRSA (877-464-4772)
between 9:00 am to 5:30 pm ET or email <callcenter@hrsa.gov>.

Please visit HRSA EHBs for online help. Go to:

<https://grants.hrsa.gov/webexternal/home.asp> and click on 'Help'

### 5.1.3 HRSA Program Support {#hrsa-program-support .unnumbered}

For assistance with program guidance related questions, please contact
the program contact listed on the program guidance. Do not call the
program contact for technical questions related to either Grants.gov or
HRSA EHBs.

# 

## 6. FAQs

## 6.1 Software {#software .unnumbered}

### 6.1.1 What are the software requirements for using Grants.gov? {#what-are-the-software-requirements-for-using-grants.gov .unnumbered}

Applicants will need to download the PureEdge viewer. Grants.gov website
provides the following information:

**System Requirements:**

For PureEdge Viewer to function properly, your computer must meet the
following system requirements:

Windows 98, ME, NT 4.0, 2000, XP\
500 Mhz processor\
128 MB of RAM\
40 MB disk space\
Web browser: Internet Explorer 5.01 or higher, Netscape Communicator
4.5 - 4.8, Netscape 6.1, 6.2, or 7

If you do not have a Windows operating system, you will need to use a
Windows Emulation program.

Please visit <http://www.grants.gov/DownloadViewer> for all details and
any updates.

### 6.1.2 Why can't I download PureEdge Viewer onto my machine? {#why-cant-i-download-pureedge-viewer-onto-my-machine .unnumbered}

Depending on your organization's computer network and security protocols
you may not have the necessary permissions to download software onto
your workstation. Contact your IT department or system administrator to
download the software for you or give you access to this function.

### 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What do I do if I use only a Macintosh? {#i-have-heard-that-grants.gov-is-not-macintosh-compatible.-what-do-i-do-if-i-use-only-a-macintosh .unnumbered}

Grants.gov is aware of the issues facing Macintosh users who apply for
Federal grants electronically. Grants.gov has provided the following
response regarding this issue on its website at
<http://www.grants.gov/MacSupport>:

> *Grants.gov recognizes that support to users of Non-Windows operating
> systems and the PureEdge Viewer is often required across a distinct
> segment of the grant applicant community. Although at this time, the
> PureEdge Viewer is only available for Windows based installs,
> Grants.gov offers support for Non-Windows platforms.*
>
> *Grants.gov is working with PureEdge in the development of a
> Non-Windows compatible viewer. PureEdge has committed to providing a
> platform independent viewer by November 2006. Information related to
> the Non-Windows compatible viewer will be posted to this webpage
> (http://www.grants.gov/MacSupport). Please bookmark this page and
> return at your convenience for more details.*

Grants.gov and NIH have partnered to provide free access to Citrix
servers for Macintosh Users who are looking for an alternative to using
PC emulation software with the PureEdge forms. A Citrix server
connection allows Macintosh users to remotely launch a Windows session
on their own machines by using the free Citrix client application.
Applicants will need to download and install the free Citrix client
application in order to work. This service is now available for use.

Grants.gov website states:

> *Beginning December 20, 2005, non-Windows users will be able to
> download and complete the PureEdge forms by taking advantage of the
> free Citrix server. Non-Windows users are also able to submit
> completed grant applications via the Citrix environment.*

For details, please visit <http://www.grants.gov/MacSupport>

### 6.1.4 What are the software requirements for HRSA EHBs? {#what-are-the-software-requirements-for-hrsa-ehbs .unnumbered}

HRSA EHBs can be accessed over the Internet using Internet Explorer (IE)
v5.0 and above and Netscape 4.72 and above. HRSA EHBs are 508 compliant.

IE 6.0 and above is the recommended browser.

HRSA EHBs use pop-up screens to allow users to view or work on multiple
screens. Ensure that your browser settings allow for pop-ups.

In addition, to view attachments such as Word and PDF, you will need
appropriate viewers.

### 6.1.5 What are the system requirements for using HRSA EHBs on a Macintosh computer?  {#what-are-the-system-requirements-for-using-hrsa-ehbs-on-a-macintosh-computer .unnumbered}

Mac users are requested to download the latest version of Netscape for
their OS version. It is recommended that Safari v1.2.4 and above or
Netscape v7.2 and above be used.

Note that Internet Explorer (IE) for Mac has known issues with SSL and
Microsoft is no longer supporting IE for Mac. HRSA EHBs do not work on
IE for Mac.

In addition, to view attachments such as Word and PDF, you will need
appropriate viewers.

## 6.2 Application Receipt {#application-receipt .unnumbered}

### 6.2.1 What will be the receipt date\--the date the application is stamped as received by Grants.gov or the date the data is received by HRSA? {#what-will-be-the-receipt-date--the-date-the-application-is-stamped-as-received-by-grants.gov-or-the-date-the-data-is-received-by-hrsa .unnumbered}

**Competing Submissions:**

The submission/receipt date will be the date the application is received
by Grants.gov.

**Noncompeting Submissions:**

The submission/receipt date will be the date the application is
submitted in HRSA EHBs.

### 6.2.2 When do I need to submit my application? {#when-do-i-need-to-submit-my-application .unnumbered}

**Competing Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

**Noncompeting Submissions:**

Applications must be submitted to Grants.gov by 8 PM ET on the due date.

Applications must be verified and submitted in HRSA EHBs by 5:00 PM ET
on the due date. (2 weeks after the due date in Grants.gov) Refer to the
program guidance for specific dates.

###  {#section-5 .unnumbered}

### 6.2.3 What emails can I expect once I submit my application? Is email reliable? {#what-emails-can-i-expect-once-i-submit-my-application-is-email-reliable .unnumbered}

**Competing Submissions:**

When you submit your noncompeting application in Grants.gov, it is first
received and validated by Grants.gov. Typically, this takes a few hours
but it may take up to 48 hours during peak volumes. You should receive
two emails from Grants.gov.

The first will confirm receipt of your application by the Grants.gov
system ("Received"), and the second will indicate that the application
has either been successfully validated ("Validated") by the system prior
to transmission to the grantor agency or has been rejected due to errors
("Rejected with Errors").

Subsequently, the application will be downloaded by HRSA. This happens
within minutes of when your application is successfully validated by
Grants.gov and made available for HRSA to download. On successful
download at HRSA, the status of the application will change to "Received
by Agency" and you will receive another email from Grants.gov.

You will receive an additional email from HRSA once your signed face
page is received and processed. This email serves as the official
receipt for your application.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

**Noncompeting Submissions:**

When you submit your noncompeting application in Grants.gov, it is first
received and validated by Grants.gov. Typically, this takes a few hours
but it may take up to 48 hours during peak volumes. You should receive
two emails from Grants.gov.

Subsequently, the application will be downloaded by HRSA. This happens
within minutes of when your application is successfully validated by
Grants.gov and made available for HRSA to download. On successful
download at HRSA, the status of the application will change to "Received
by Agency" and you will receive another email from Grants.gov.

Subsequently, it is processed by HRSA to ensure that the application is
submitted for the correct funding announcement, with the correct grant
number and grantee organization. This may take up to 3 business days. At
this point you will receive an email from HRSA confirming the successful
receipt of your application and asking the PD and AO to review and
resubmit the application in HRSA EHBs.

You will receive an additional email from HRSA once your signed face
page is received and processed. This email serves as the official
receipt for your application.

Because email is not reliable, you must check the respective systems if
you do not receive any emails within the specified timeframes.

-   For more information refer to sections 2.4 and 2.5 in this guide

### 6.2.4 If a resubmission is required because of Grants.gov system problems, will these be considered \"late\"? {#if-a-resubmission-is-required-because-of-grants.gov-system-problems-will-these-be-considered-late .unnumbered}

**Competing Submissions:**

No. But you must **contact the Director of the Division of Grants
Policy** via email at <DGPClearances@hrsa.gov> and thoroughly explain
the situation. Include a copy of the "Rejected with Errors" notification
you received from Grants.gov.

**Noncompeting Submissions:**

No. But you must **contact the HRSA Call Center** at 877-GO4-HRSA
(877-464-4772) between 9:00 am to 5:30 pm ET or email
<callcenter@hrsa.gov>. You may be asked to provide a copy of the
"Rejected with Errors" notification you received from Grants.gov.

## 6.3 Application Submission {#application-submission .unnumbered}

### 6.3.1 How can I make sure that my electronic application is presented in the right order for objective review? {#how-can-i-make-sure-that-my-electronic-application-is-presented-in-the-right-order-for-objective-review .unnumbered}

Follow the instructions provided in section to ensure that your
application is presented in the right order and is compliant with all
the requirements.

## 6.4 Grants.gov {#grants.gov .unnumbered}

For a list of frequently asked questions and answers maintained by
Grants.gov please visit the following URL:

<http://www.grants.gov/GrantsGov_UST_Grantee/!SSL!/WebHelp/GrantsGov_UST_Grantee.htm#index.html>

**Appendix B -- Registering and Applying Through Grants.gov**

**Prepare to Apply through Grants.gov:**

HRSA, in providing the grant community a single site to Find and Apply
for grant funding opportunities, is [requiring]{.underline} applicants
for this funding opportunity to apply electronically through Grants.gov.
By using Grants.gov you will be able to download a copy of the
application package, complete it off-line, and then upload and submit
the application via the Grants.gov site. You may [not]{.underline}
e-mail an electronic copy of a grant application to us.

Please understand that we will not consider additional information
and/or materials submitted after your initial application. You must
therefore ensure that all materials are submitted together.

Note: Except in rare cases, paper applications will NOT be accepted for
this grant opportunity. If you believe you are technologically unable to
submit an on-line application you MUST contact the Director of the
Division of Grants Policy, at
[DGPClearances@hrsa.gov](../DGPClearances@hrsa.gov%20) and explain why
you are technologically unable to submit on-line. Make sure you specify
the announcement number you are requesting relief for. HRSA and its
Grants Application Center (GAC) will only accept paper applications from
applicants that received prior written approval.

In order to apply through Grants.gov the Applicant must register with
Grants.gov. This is a three step process that must be completed by any
organization wishing to apply for a grant opportunity. The registration
process will require some time. Therefore, applicants or those
considering applying at some point in the future should register
**[immediately]{.underline}**. Registration in Grants.gov does not
require the organization to apply for a grant; it simply provides the
organization the required credentials so that the organization may apply
for a grant in the future. Registration is required only once.

**[REGISTRATION:]{.underline}**

GET STARTED NOW AND COMPLETE THE ONE-TIME REGISTRATION PROCESS TO BEGIN
SUBMITTING GRANT APPLICATIONS AS SOON AS YOU READ THIS.

You don't need to be registered to search or to begin selecting,
downloading and completing grant applications. Registration is required
to submit applications. Therefore, it is essential that your
organization be registered prior to attempting to submit a grant
application or your organization will not be able to do so. **Be sure to
complete the process early as the registration process may take some
time (anywhere from 5 days to 1 month).**

**There are three steps to the registration process:**

Step 1: Register your organization

Step 2: Register yourself as an Authorized Organization Representative

Step 3: Get authorized by your organization to submit grants

These instructions will walk you through the three basic registration
steps. Additional assistance is available at Grants.gov at
[www.grants.gov](../www.grants.gov). Individual assistance is available
at [http://www.grants.gov/Support](http://www.grants.gov/Support  ) or
1-800-447-8477. Grants.gov also provides a variety of support options
through online Help including Context-Sensitive Help, Online Tutorials,
FAQs, Training Demonstration, User Guide, and Quick Reference Guides.

Follow this checklist to complete your registration---

1\. Register Your Organization

\- Obtain your organization's Data Universal Number System (DUNS) number

\- Register your organization with Central Contractor Registry (CCR)

\- Identify your organization's E-Business POC (Point of Contact)

\- Confirm your organization's CCR "Marketing Partner ID Number (M-PIN)"
password

2\. Register Yourself as an Authorized Organization Representative (AOR)

\- Obtain your username and password

\- Register your username and password with Grants.gov

3\. Get Yourself Authorized as an AOR

\- Contact your E-Business POC to ensure your AOR status

\- Log in to Grants.gov to check your AOR status

The Grants.gov/Apply feature includes a simple, unified application
process to enable applicants to apply for grants online. The information
applicants need to understand and execute the steps is at
http://www.grants.gov/GetStarted. Applicants should read the Get Started
steps carefully. The site also contains registration checklists to help
you walk through the process. HRSA recommends that you download the
checklists and prepare the information requested before beginning the
registration process. Reviewing information required and assembling it
before beginning the registration process will save you time and make
the process faster and smoother.

**REGISTER YOUR ORGANIZATION**

Before you can apply for a grant via Grants.gov, your organization must
obtain a Data Universal Number System (DUNS) number and register early
with the Central Contractor Registry (CCR).

**Obtain your organization's DUNS number**

A DUNS number is a unique number that identifies an organization. It has
been adopted by the Federal government to help track how Federal grant
money is distributed. Ask your grant administrator or chief financial
officer to provide your organization's DUNS number.

\-**How do you do it**? If your organization does not have a DUNS
number, call the special Dun & Bradstreet hotline at 1-866-705-5711 to
receive one free of charge.

\- **How long will this take?** You will receive a DUNS number at the
conclusion of the phone call.

**Register your organization with CCR**

The CCR is the central government repository for organizations working
with the Federal government. Check to see if your organization is
already registered at the CCR website. If your organization is not
already registered, identify the primary contact who should register
your organization.

When your organization registers with CCR, it will be required to
designate an E-Business Point of Contact (E-Business POC). The designee
authorizes individuals to submit grant applications on behalf of the
organization and creates a special password called a Marketing Partner
ID Number (M-PIN) to verify individuals authorized to submit grant
applications for the organization.

\-**How do you do it?** Visit the CCR website at http://www.ccr.gov.
Check whether your organization is already registered or register your
organization right online. Be certain to enter an MPIN number during
this process as this is an optional field for the CCR registration but
mandatory for Grants.gov.

\- **How long will this take?** It may take a few days for you to
collect the information needed for your organization's registration, but
once you finish the registration process, you can move on to Step 2 the
very next business day. Note it will take up to a month for the total
registration- therefore this should be done as soon as possible.

**GET AUTHORIZED as an AOR by Your Organization**

The registration process is almost complete. All that remains is the
final step ---getting authorized. Even though you have registered, your
E-Business POC must authorize you so Grants.gov will know that you are
verified to submit applications.

\- **Obtain your E-Business POC authorization**

After your Authorized Organizational Representative (AOR) profile is
completed, your organization's E-Business POC will receive an email
regarding your requested AOR registration, with links and instructions
to authorize you as an AOR.

\- **How do you do it?** Instruct your E-Business POC to login to
Grants.gov at http://www.grants.gov/ForEbiz and enter your
organization's DUNS number and M-PIN. They will select you as an AOR
they wish to authorize and you will be verified to submit grant
applications.

\- **How long will this take?** It depends on how long it takes your
E-Business POC to log in and authorize your AOR status. You can check
your AOR status by logging in to Grants.gov at
http://www.grants.gov/ForApplicants.

**REGISTER YOURSELF as an Authorized Organization Representative (AOR)**

Once the CCR Registration is complete, your organization is finished
registering. You must now register yourself with Grants.gov and
establish yourself as an AOR, an individual authorized to submit grant
applications on behalf of your organization. There are two elements
required to complete this step --- both must be completed to move onto
Step 3.

1\. **Obtain your username and password**

In order to safeguard the security of your electronic information, and
to submit a Federal grant application via Grants.gov, you must first
obtain a username and password from the Grants.gov Credential Provider.

\- **How do you do it**? Just register with Grants.gov's Credential
Provider at http://www.grants.gov/Register1. You will need to enter your
organization's DUNS number to access the registration form. Once you
complete the registration form you will be given your username and you
will create your own password.

\- **How long will this take?** Same day. When you submit your
information you will receive your username and be able to create your
password.

**2. Register with Grants.gov**

Now that you have your username and password, allow about 30 minutes for
your data to transfer from the Credential Provider, then you must
register with Grants.gov to set up a short profile.

\> **How do you do it?** Simply visit http://www.grants.gov/Register2 to
register your username and password and set up your profile. Remember,
you will only be authorized for the DUNS number which you register in
your Grants.gov profile.

\> **How long will this take?** Same day. Your AOR profile will be
complete after you finish filling in the profile information and save
the information at Grants.gov.

You have now completed the registration process for Grants.gov. If you
are applying for a [new or competing continuation]{.underline} you may
find the application package through Grants.gov FIND. If you are filling
out a [non-competing continuation]{.underline} application you must
obtain the announcement number through your program office, and enter
this announcement number in the search field to pull up the application
form and related program guidance. Download the required forms and enter
your current grant number in the appropriate field to begin the
non-competing continuation application which you will then upload for
electronic submittal through Grants.gov. For continuation applications
which require submittal of performance measures electronically,
instructions are provided in the program guidance on how to enter the
HRSA electronic handbooks to provide this information.

**How to submit an electronic application to HRSA via Grants.gov/Apply**

a\. [Applying using Grants.gov.]{.underline} Grants.gov has a full set
of instructions on how to apply for funds on its website at
<http://www.grants.gov/CompleteApplication>. The following provides
simple guidance on what you will find on the Grants.gov/Apply site.
Applicants are encouraged to read through the page entitled, "Complete
Application Package" before getting started. See Appendix A for specific
information.

b\. [Customer Support]{.underline}. The grants.gov website provides
customer support via (800) 518-GRANTS (this is a toll-free number) or
through e-mail at support@grants.gov. The customer support center is
open from 7:00 a.m. to 9:00 p.m. Eastern time, Monday through Friday,
except federal holidays, to address grants.gov technology issues. For
technical assistance to program related questions, contact the number
listed in the Program Section of the program you are applying for.

**Timely Receipt Requirements and Proof of Timely Submission**

a\. Electronic Submission. All applications must be received by
www.grants.gov/Apply by 8:00 P.M. Eastern Time on the due date
established for each program.

Proof of timely submission is automatically recorded by Grants.gov. An
electronic time stamp is generated within the system when the
application is successfully received by Grants.gov. The applicant will
receive an acknowledgement of receipt and a tracking number from
Grants.gov with the successful transmission of their application.
Applicants should print this receipt and save it, along with facsimile
receipts for information provided by facsimile, as proof of timely
submission. When HRSA successfully retrieves the application from
Grants.gov, Grants.gov will provide an electronic acknowledgment of
receipt to the e-mail address of the AOR. Proof of timely submission
shall be the date and time that Grants.gov receives your application.

Applications received by grants.gov, after the established due date and
time for the program, will be considered late and will not be considered
for funding by HRSA. HRSA suggests that applicants submit their
applications during the operating hours of the Grants.gov Support Desk,
so that if there are questions concerning transmission, operators will
be available to walk you through the process. Submitting your
application during the Support Desk hours will also ensure that you have
sufficient time for the application to complete its transmission prior
to the application deadline. Applicants using dial-up connections should
be aware that transmission should take some time before Grants.gov
receives it. Grants.gov will provide either an error or a successfully
received transmission message. The Grants.gov Support desk reports that
some applicants abort the transmission because they think that nothing
is occurring during the transmission process. Please be patient and give
the system time to process the application. Uploading and transmitting
many files, particularly electronic forms with associated XML schemas,
will take some time to be processed.

Note the following additional information regarding submission of all
HRSA applications through Grants.gov:

• You must submit all documents electronically, including all
information typically included on the SF424 and all necessary assurances
and certifications.

• Your application must comply with any page limitation requirements
described in this program announcement.

• After you electronically submit your application, you will receive an
automatic acknowledgement from Grants.gov that contains a Grants.gov
tracking number. HRSA will retrieve your application from Grants.gov.

Online applications are required to submit ONLY one form in signed hard
copy: the SF-424/5161 Face Sheet, since all other elements of the
application have been captured and transmitted electronically. This face
page should be sent to HRSA's Grants Application Center at:

The HRSA Grants Application Center

The Legin Group, Inc.

Attn: \[provide Grants.gov Tracking Number\]

> Program Announcement No. \[provide HRSA announcement number\]
>
> CFDA No. \[provide the CFDA number\]

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

Telephone: 877-477-2123

**Formal Submission of the Electronic Application**

Applications completed online are considered formally submitted when the
Authorizing Official electronically submits the application to HRSA
through Grants.gov. However, to complete the submission requirements, a
hard-copy of the SF-424/5161 Face Sheet must be printed, signed, and
submitted to the HRSA Grants Application Center. For competitive
applications, the SF-424/5161 must be printed from Grants.gov.

For an online application, the signed SF-424/5161 must be sent to the
HRSA GRANTS APPLICATION CENTER at the above address and received by HRSA
by no later than five days after the date of submission in Grants.gov.

Competitive applications will be considered as having met the deadline
if: (1) the application has been successfully transmitted electronically
by your organization's Authorizing Official through Grants.gov on or
before the deadline date and time, and (2) the signed SF-424/5161 Face
Sheet is received by HRSA no later than five days after submission in
Grants.gov.

**Performance Measures for Competitive Applications**

Many HRSA guidances include specific data forms and require performance
measure reporting. If the completion of performance measure information
is indicated in this guidance, successful applicants receiving grant
funds will be required, within 30 days of the Notice of Grant Award
(NGA), to register in HRSA's Electronic Handbooks (EHBs) and
electronically complete the program specific data forms that appear in
this guidance. This requires the provision of budget breakdowns in the
financial forms based on the grant award amount, the project abstract
and other grant summary data, and objectives for the performance
measures.

**Performance Measures for Non-Competing Continuation Applications**

For applications which require submittal of performance measures
electronically through the completion of program specific data forms,
instructions will be provided both in the program guidance and through
an e-mail, notifying grantees of their responsibility to provide this
information, and providing instructions on how to do so.

**APPENDIX C**

**[Instructions for the SF424 R&R (Research and Related)]{.underline}**

This application form is replacing the 6025 training application form
and the 398 application form. The 424 R&R will be used for all HRSA
training and research programs.

**INSTRUCTIONS FOR THE APPLICATION FACE PAGES**

Below are detailed instructions for the completion of the 424 R&R form:

+----+-----------------------------------------------------------------+
| F  | Instructions                                                    |
| ie |                                                                 |
| ld |                                                                 |
+----+-----------------------------------------------------------------+
| 1  | Select **Type of Submission**: Check the appropriate type from  |
| \. | the submission options. Select **Application** for all HRSA     |
|    | grant programs                                                  |
+----+-----------------------------------------------------------------+
| 2  | **Date Submitted**: Enter the date the application is submitted |
| \. | to the Federal agency.                                          |
+----+-----------------------------------------------------------------+
| 3  | **Date Received by State**: State Use Only (if applicable)      |
| \. |                                                                 |
+----+-----------------------------------------------------------------+
| 4  | **Federal Identifier**: New Project Applications should leave   |
| \. | this field blank. If this is a Continuation application         |
|    | (competing or non-competing) or a Supplement, enter your grant  |
|    | number located on your Notice of Grant Award (NGA.              |
+----+-----------------------------------------------------------------+
| 5  | **Applicant Information**: All items in bold are required       |
| \. | fields and must be completed                                    |
|    |                                                                 |
|    | Enter your **Organization's DUNS** Number (received from Dun    |
|    | and Bradstreet), Enter the **Legal Name**, **Applicant          |
|    | Department** (if applicable) and **Division** (if applicable)   |
|    | who will undertake the assistance activity. In **Street 1**     |
|    | enter the first line of the street address of your              |
|    | organization. In **Street2** enter the second line of your      |
|    | organization, if applicable. Enter the **City, County** and     |
|    | **State,** **Zip Code** and **Country** where your organization |
|    | is located. Enter the **Person to be Contacted on Matters       |
|    | Involving the Application:**                                    |
|    |                                                                 |
|    | **This is the POINT OF CONTACT, the person to be contacted**    |
|    | for the matters pertaining to this specific application (i.e.   |
|    | principle investigator, project director, other )**.** Enter    |
|    | the **Prefix, First Name, Middle Name and Last Name and         |
|    | Suffix** (if applicable) of the person to be contacted on       |
|    | matters relating to this application. Enter the **Phone** and   |
|    | **Fax** number as well as the **E-MAIL** address of this        |
|    | person. **These are all required fields.**                      |
+----+-----------------------------------------------------------------+
| 6  | **Employer Identification (EIN)/ (TIN)**                        |
| \. |                                                                 |
|    | Enter the 9 Digit Employer Identification Number as Assigned by |
|    | the Internal Revenue Services.                                  |
+----+-----------------------------------------------------------------+
| 7  | **Type of Applicant :** Select the appropriate letter from one  |
| \. | of the following:                                               |
|    |                                                                 |
|    | A.  State Government                                            |
|    |                                                                 |
|    | B.  County Government                                           |
|    |                                                                 |
|    | C.  City or Township Government                                 |
|    |                                                                 |
|    | D.  Special District Government                                 |
|    |                                                                 |
|    | E.  Independent School District                                 |
|    |                                                                 |
|    | F.  State Controlled Institution of Higher Education            |
|    |                                                                 |
|    | G.  Native American Tribal Government (Federally Recognized)    |
|    |                                                                 |
|    | H.  Public/Indian Housing Authority                             |
|    |                                                                 |
|    | I.  Native American Tribal Organization (other than Federally   |
|    |     recognized)                                                 |
|    |                                                                 |
|    | J.  Nonprofit with 501C3 IRS status (other than Institute of    |
|    |     Higher Education)                                           |
|    |                                                                 |
|    | K.  Nonprofit without 501C3 IRS status (other than Institute of |
|    |     Higher Education                                            |
|    |                                                                 |
|    | L.  Private Institution of Higher Education                     |
|    |                                                                 |
|    | M.  Individual                                                  |
|    |                                                                 |
|    | N.  For Profit Organization(other than small business)          |
|    |                                                                 |
|    | O.  Small Business                                              |
|    |                                                                 |
|    | P.  Other (specify)                                             |
|    |                                                                 |
|    | **Women Owned:** Check if you are a woman owned small business( |
|    | 51% owned/controlled and operated by a woman/women)             |
|    |                                                                 |
|    | **Socially and Economically Disadvantaged:** Check if you are a |
|    | socially and economically disadvantaged small business, as      |
|    | determined by the U.S. SBA pursuant to Section 8(a) of the SBA  |
|    | U.S.C. 637(a).                                                  |
+----+-----------------------------------------------------------------+
| 8  | **Type of Application: Select the Type from the following list  |
| \. | :**                                                             |
|    |                                                                 |
|    | \- **New**: A new assistance award                              |
|    |                                                                 |
|    | \- **Resubmission** ( not applicable to HRSA)                   |
|    |                                                                 |
|    | \- **Renewal --** An application for a competing continuation   |
|    | -- this is a request for an extension for an additional         |
|    | funding/budget period for a project with a projected            |
|    | completion.                                                     |
|    |                                                                 |
|    | \-**Continuation**: A non-competing application for an          |
|    | additional funding/budget period for a project within a         |
|    | previously approved projected period                            |
|    |                                                                 |
|    | \- **Revision**: Any change in the Federal Governments          |
|    | financial obligation or contingent liability from an existing   |
|    | obligation. Indicate the **Type of Revision** by checking the   |
|    | appropriate box:                                                |
|    |                                                                 |
|    | A. Increase in Award (supplement, competing supplement)         |
|    |                                                                 |
|    | B. Decrease Award                                               |
|    |                                                                 |
|    | C. Increase Duration                                            |
|    |                                                                 |
|    | D. Decrease Duration                                            |
|    |                                                                 |
|    | E. Other (Enter text to Explain)                                |
|    |                                                                 |
|    | **Is Application being submitted to Other Agencies:** Indicate  |
|    | by checking **YES** or **NO** if the application is being       |
|    | submitted to HRSA only.                                         |
|    |                                                                 |
|    | **What other Agencies:** Enter Agency Name ( if applicable)     |
+----+-----------------------------------------------------------------+
| 9  | **Name of Federal Agency:** Enter the Name of the Federal       |
| \. | Agency from which assistance is being requested                 |
+----+-----------------------------------------------------------------+
| 10 | **Catalogue of Federal Domestic Assistance Number (CFDA):** Use |
| \. | the CFDA Number found on the front page of the program guidance |
|    | and associated Title of the CFDA (if available).                |
+----+-----------------------------------------------------------------+
| 11 | **Descriptive Title of Applicant's Project:** Enter a brief     |
| \. | descriptive title of the project**.** A continuation or         |
|    | revision must use the same title as the currently funded        |
|    | project.                                                        |
+----+-----------------------------------------------------------------+
| 12 | **Areas Affected by Project**: List only the largest political  |
| \. | Entities affected by the project ( ex. states, counties,        |
|    | cities)                                                         |
+----+-----------------------------------------------------------------+
| 13 | **Proposed Project:** Enter the project **Start Date** of the   |
| \. | project in the Start Date Field and the project **Ending Date** |
|    | in the Ending Date Field. ( ex.11/01/2005 to 10/31/2008)        |
+----+-----------------------------------------------------------------+
| 14 | **Congressional District Applicant and Congressional District   |
| \. | Project:** Enter your Congressional District(s) in Applicant    |
|    | Field. Enter the Congressional District (s) of Project, the     |
|    | primary site where the project will be performed.               |
|    | (http://www.gpoaccess.gov/cdirectory/browse-cd-05.html)         |
+----+-----------------------------------------------------------------+
| 15 | **Project Director/Principal Investigator Contact Information   |
| \. | :** All items in bold are required fields and must be completed |
|    |                                                                 |
|    | Enter the **Prefix, First Name, Middle Name and Last Name and   |
|    | Suffix** (if applicable) of the Project Director/Principle      |
|    | Investigator (PD/PI) for the project. Enter the **Title** of    |
|    | the PD/PI and the **name of the organization** of the PD/PI.    |
|    | Enter the name of the primary organization **Department** and   |
|    | **Division** of the PD/PI. In **Street 1** enter the first line |
|    | of the street address of the PD/PI for the project. In          |
|    | **Street2** enter the second line of the street address for the |
|    | PD/PI, if applicable. Enter the **City, County** and **State,** |
|    | **Zip Code** and **Country** of the PD/PI. Enter the **Phone**  |
|    | and **Fax** number as well as the **E-MAIL** address of this    |
|    | person. **These are all required fields.**                      |
+----+-----------------------------------------------------------------+
| 16 | **Estimated Project Funding:**                                  |
| \. |                                                                 |
|    | **a. Total Estimated Project Funding** Enter the total          |
|    | **Federal Funds** requested for the **BUDGET PERIOD** for which |
|    | you are applying**. Enter only the amount for the year you are  |
|    | applying, NOT the amount for the entire project period.**       |
|    |                                                                 |
|    | **b. Total Federal and Non-Federal Funds:** Enter the total     |
|    | Federal and non-Federal funds for the **BUDGET PERIOD** for     |
|    | which you are applying.                                         |
|    |                                                                 |
|    | **c.** **Estimated Program Income:** Identify any Program       |
|    | Income for the **BUDGET PERIOD.**                               |
+----+-----------------------------------------------------------------+
| 17 | **Is Application Subject to Review by State Executive Order     |
| \. | 12372 Process:**                                                |
|    |                                                                 |
|    | If YES: Check the YES box if the announcement indicates that    |
|    | the program is covered under State Executive Order 12372. If    |
|    | NO: Place a check in the NO box.                                |
+----+-----------------------------------------------------------------+
| 18 | **Complete Certification**                                      |
| \. |                                                                 |
|    | Check the "I agree" box to attest to acceptance of required     |
|    | certifications and assurances listed at the end of the          |
|    | Application**.**                                                |
+----+-----------------------------------------------------------------+
| 19 | **Authorized Representative** (Authorizing Official - This is   |
| \. | the person who has the authority to sign the application for    |
|    | the organization ) All items in bold are required fields and    |
|    | must be completed                                               |
|    |                                                                 |
|    | Enter the name of Authorized Representative/Authorizing         |
|    | Official. Enter the **Prefix, First Name, Middle Name and Last  |
|    | Name and Suffix** (if applicable) of the Authorized             |
|    | Representative (AR) or Authorizing Official (AO). Enter the     |
|    | **Title** of the Authorized Representative and the              |
|    | **organization** of the AR/AO. Enter the name of the primary    |
|    | organization **Department** and **Division** of the AO. In      |
|    | **Street1** enter the first line of the street address of the   |
|    | AR/AO for the project. In **Street2** enter the second line of  |
|    | the street address for the AR/AO, if applicable. Enter the      |
|    | **City, County** and **State,** **Zip Code** and **Country** of |
|    | the AR/AO. Enter the **Phone** and **Fax** number as well as    |
|    | the **E-MAIL** address of AR/AO this person. **These are all    |
|    | required fields.**                                              |
|    |                                                                 |
|    | **Date Signed: If you are submitting this electronically please |
|    | print off a copy of the face/cover pages of the application,    |
|    | sign and send them to HRSA's Grants Application Center (GAC)    |
|    | --( See the program guidance for the GAC's address)**           |
|    |                                                                 |
|    | Note: Applicant applying in paper must send their entire grant  |
|    | application with the signed face/cover pages to the GAC         |
+----+-----------------------------------------------------------------+
| 20 | **Pre-Application**                                             |
| \. |                                                                 |
|    | This is Not applicable to HRSA. A limited number of HRSA        |
|    | programs require a Letter of Intent which is different from a   |
|    | preapplication. Information required and the process for        |
|    | submitting such a Letter of Intent is outlined in the funding   |
|    | opportunity announcements for those programs with such a        |
|    | requirement. .                                                  |
+----+-----------------------------------------------------------------+

INSTRUCTIONS FOR 5161 CHECKLIST (This is used for the 424 R&R as well)

+-----------------+----------------------------------------------------+
| Field           | Instructions                                       |
+-----------------+----------------------------------------------------+
| Type of         | Check one of the boxes corresponding to one of the |
| Application     | following types:                                   |
|                 |                                                    |
|                 | \- **New**: A new application is a request for     |
|                 | financial assistance for a project or program not  |
|                 | currently receiving DHHS support.                  |
|                 |                                                    |
|                 | **-Non competing Continuation**: A non-competing   |
|                 | application for an additional funding/budget       |
|                 | period for a project within a previously approved  |
|                 | project period                                     |
|                 |                                                    |
|                 | \- **Competing Continuation (** same as Renewal    |
|                 | from 424R&R face page)                             |
|                 |                                                    |
|                 | --this is a request for an extension of support    |
|                 | for an additional funding/budget period for a      |
|                 | project with a projected completion.               |
|                 |                                                    |
|                 | **- Supplemental (**same as Revision from 424 R&R  |
|                 | face page) An application requesting a change in   |
|                 | the Federal Governments financial obligation or    |
|                 | contingent liability from an existing obligation.  |
+-----------------+----------------------------------------------------+
| Part A          | Leave this Section Blank                           |
+-----------------+----------------------------------------------------+
| Part B          | Leave this Section Blank                           |
+-----------------+----------------------------------------------------+
| Part C          | In the Space Provided below, please provide the    |
|                 | requested information                              |
+-----------------+----------------------------------------------------+
| Business        | Enter the name of Business Official to be notified |
| Official to be  | if an award is to be made. Enter the **Prefix,     |
| notified if an  | First Name, Middle Name and Last Name and Suffix** |
| award is to be  | (if applicable) of the Business Official and the   |
| made            | **organization. Enter the Address** **Street1.**   |
|                 | Enter the first line of the street address of the  |
|                 | Business Official. In **Street2** enter the second |
|                 | line of the street address for the AR/AO, if       |
|                 | applicable. Enter the **City, County** and         |
|                 | **State,** **Zip Code** and **Country** of the     |
|                 | business official. Enter the **Telephone** and     |
|                 | **Fax** number as well as the **E-MAIL** address   |
|                 | of Business Official. Enter the Applicant          |
|                 | Organizations 12 Digit DHHS EIN ( if already       |
|                 | assigned) -- This should be the same information   |
|                 | as supplied in file number 5 of the 424 R&R face   |
|                 | page .                                             |
+-----------------+----------------------------------------------------+
| Project         | Enter the name of Project Director/Principle       |
| Dir             | Investigator (PD/PI) -- this should be the same    |
| ector/Principle | information as supplied on the 424 R & R face page |
| Investigator    | field number 15. Enter the **Prefix, First Name,   |
| designated to   | Middle Name and Last Name and Suffix** (if         |
| direct the      | applicable). Enter the name of the primary         |
| proposed        | organization and Address: **Street1** enter the    |
| project         | first line of the street address of the AR/AO for  |
|                 | the project. In **Street2** enter the second line  |
|                 | of the street address for the AR/AO, if            |
|                 | applicable. Enter the **City, County** and         |
|                 | **State,** **Zip Code** and **Country** of the     |
|                 | PD/PI. Enter the **Telephone Number, E-Mail** and  |
|                 | **Fax** number. **DO NOT** enter the social        |
|                 | security number. Enter the highest degree earned   |
|                 | for the PD/PI.                                     |
+-----------------+----------------------------------------------------+

INSTRUCTIONS FOR R&R SENIOR/KEY PERSON PROFILE

Starting with the PD/PI, provide a profile for each senior/key person
proposed. Unless otherwise specified in an agency announcement senior
key personnel are defined as all individuals who contribute in a
substantive, measurable way to the execution of the project or activity
whether or not salaries are requested. Consultants should be included if
they meet this definition. For each of these individuals a Biosketch
should be attached which lists the individual's credentials/degrees.

+-------------+--------------------------------------------------------+
| Field       | Instruction                                            |
+-------------+--------------------------------------------------------+
| Prefix      | Ex. Mr., Ms. Mrs. Rev. Enter the Prefix for the        |
|             | Individual identified as a key person for the project. |
|             | If this is the entry for the Project Director and you  |
|             | are submitting electronically this field will be       |
|             | prepopulated with the prefix for the project director  |
|             | identified on the face page of the 424 R&R.            |
+-------------+--------------------------------------------------------+
| First Name  | This is the first (given) name of the Individual       |
|             | identified as a key person for the project. If this is |
|             | the entry for the Project Director and you are         |
|             | submitting electronically this field will be           |
|             | prepopulated with the name of the project director     |
|             | identified on the face page of the 424 R&R.            |
+-------------+--------------------------------------------------------+
| Middle Name | This is the middle name of the Individual identified   |
|             | as a key person for the project. If this is the entry  |
|             | for the Project Director and you are submitting        |
|             | electronically this field will be prepopulated with    |
|             | the name of the project director identified on the     |
|             | face page of the 424 R&R.                              |
+-------------+--------------------------------------------------------+
| Last Name   | This is the last name of the Individual identified as  |
|             | a key person for the project. If this is the entry for |
|             | the Project Director and you are submitting            |
|             | electronically this field will be prepopulated with    |
|             | the last name of the project director identified on    |
|             | the face page of the 424 R&R.                          |
+-------------+--------------------------------------------------------+
| Suffix      | Enter the Suffix (Ex. Jr., Sr., Ph.D.) for the         |
|             | Individual identified as a key person for the project. |
|             | If this is the entry for the Project Director and you  |
|             | are submitting electronically this field will be       |
|             | prepopulated with the prefix for the project director  |
|             | identified on the face page of the 424 R&R.            |
+-------------+--------------------------------------------------------+
| Pos         | Enter the Title for the Individual identified as a key |
| ition/Title | person for the project. If this is the entry for the   |
|             | Project Director and you are submitting electronically |
|             | this field will be prepopulated with the Title for the |
|             | project director identified on the face page of the    |
|             | 424 R&R.                                               |
+-------------+--------------------------------------------------------+
| Department  | This is the name of the primary organizational         |
|             | department, service, laboratory, or equivalent level   |
|             | within the organization for the Individual identified  |
|             | as a key person for the project. If this is the entry  |
|             | for the Project Director and you are submitting        |
|             | electronically this field will be prepopulated with    |
|             | the Department for the project director identified on  |
|             | the face page of the 424 R&R.                          |
+-------------+--------------------------------------------------------+
| O           | This is the name of the organizational for the         |
| rganization | Individual identified as a key person for the project. |
| Name        | If this is the entry for the Project Director and you  |
|             | are submitting electronically this field will be       |
|             | prepopulated with the Organization Name for the        |
|             | project director identified on the face page of the    |
|             | 424 R&R.                                               |
+-------------+--------------------------------------------------------+
| Division    | This is the primary organizational division, office,   |
|             | or major subdivision of the individual. If this is the |
|             | entry for the Project Director and you are submitting  |
|             | electronically this field will be prepopulated with    |
|             | the Division for the project director identified on    |
|             | the face page of the 424 R&R.                          |
+-------------+--------------------------------------------------------+
| Street1     | This is the first line of the street address for the   |
|             | individual identified as a key/senior person. If this  |
|             | is the entry for the Project Director and you are      |
|             | submitting electronically this field will be           |
|             | prepopulated with the Street address for the project   |
|             | director identified on the face page of the 424 R&R.   |
+-------------+--------------------------------------------------------+
| Street 2    | This is the second line of the street address (if      |
|             | applicable) for the individual identified. If this is  |
|             | the entry for the Project Director and you are         |
|             | submitting electronically this field will be           |
|             | prepopulated with the second line of the Street        |
|             | address ( if applicable) for the project director      |
|             | identified on the face page of the 424 R&R             |
+-------------+--------------------------------------------------------+
| City        | Enter the city where the key/senior person is located. |
|             | If this is the entry for the Project Director and you  |
|             | are submitting electronically this field will be       |
|             | prepopulated.                                          |
+-------------+--------------------------------------------------------+
| County      | Enter the County where the key/senior person is        |
|             | located. If this is the entry for the Project Director |
|             | and you are submitting electronically this field will  |
|             | be prepopulated.                                       |
+-------------+--------------------------------------------------------+
| State       | Enter the state where the key/senior person is         |
|             | located. If this is the entry for the Project Director |
|             | and you are submitting electronically this field will  |
|             | be prepopulated.                                       |
+-------------+--------------------------------------------------------+
| ZIP Code    | Enter the Zip Code where the key/senior person is      |
|             | located. If this is the entry for the Project Director |
|             | and you are submitting electronically this field will  |
|             | be prepopulated                                        |
+-------------+--------------------------------------------------------+
| Phone       | Enter the daytime phone number for the senior/key      |
| Number      | person. If this is the entry for the Project Director  |
|             | and you are submitting electronically this filed will  |
|             | be prepopulated                                        |
+-------------+--------------------------------------------------------+
| Fax Number  | Enter the fax number for the senior/key person. If     |
|             | this is the entry for the Project Director and you are |
|             | submitting electronically this filed will be           |
|             | prepopulated                                           |
+-------------+--------------------------------------------------------+
| Email       | Enter the email address for the senior/key person. If  |
| address     | this is the entry for the Project Director and you are |
|             | submitting electronically this filed will be           |
|             | prepopulated - This is a required field                |
+-------------+--------------------------------------------------------+
| Credential  | Leave this field blank                                 |
| e.g. agency |                                                        |
| login       |                                                        |
+-------------+--------------------------------------------------------+
| Project     | Enter the project role from the list below             |
| Role        |                                                        |
|             | 1\. Project Director (PD)/Principle Investigator(PI)   |
|             |                                                        |
|             | 2\. Co- PD/Co- PI                                      |
|             |                                                        |
|             | 3.Faculty                                              |
|             |                                                        |
|             | 4\. Post Doctoral                                      |
|             |                                                        |
|             | 5\. Post Doctoral Associate                            |
|             |                                                        |
|             | 6\. Other Professional                                 |
|             |                                                        |
|             | 7\. Graduate Student                                   |
|             |                                                        |
|             | 8\. Undergraduate Student                              |
|             |                                                        |
|             | 9\. Technician                                         |
|             |                                                        |
|             | 10\. Consultant                                        |
|             |                                                        |
|             | 11\. Other (Specify)                                   |
+-------------+--------------------------------------------------------+
| Other       | Complete if you selected "Other "as a project role.    |
| Project     | For example, Engineer, social worker.                  |
| Role        |                                                        |
| Category    |                                                        |
+-------------+--------------------------------------------------------+
| Attach      | Provide a biographical sketch for the PD/PI or Senior  |
| B           | Key Person identified. For each of these individuals a |
| iographical | Biosketch should be attached which lists the           |
| Sketch      | individual's credentials/degrees. Recommended          |
|             | information includes: education and training, research |
|             | and professional and synergistic activities. Save the  |
|             | information in a single file and attach by clicking    |
|             | Add attachment --if applying electronically            |
+-------------+--------------------------------------------------------+
| Attach      | Follow the individual program guidance pertaining to   |
| Current &   | this issue. If current and pending support on level of |
| Pending     | effort documentation is required, please attach        |
| Support     | accordingly.                                           |
+-------------+--------------------------------------------------------+
|             |                                                        |
+-------------+--------------------------------------------------------+

INSTRUCTIONS FOR R&R PROJECT PERFORMANCE SITE LOCATION(S) FORM

Indicate the primary site/sites where the work or activity will occur.
If a portion of the project is at any other location(s), identify it in
the section provided. If more than eight project/performance site
locations are proposed, provide the information in a separate file and
attach these in a file in the space provided at the bottom of the form.
If applying in paper add this information as part of the appendix.

Enter the Primary Performance Site first. Add all other performance
sites in the space provided.

  -------------- -----------------------------------------------------------
  Field name     Instructions

  Organization   Enter the Name of the Performance Site/Organization
  Name           

  Street 1       Enter the first line of the street address of the
                 performance site location

  Street 2       Enter the second line of the street address of the
                 performance site location, if applicable

  City           Enter the city of the performance site.

  County         Enter the county where the performance site is located.

  State          Select from the list of States or enter the State/province
                 in which the performance site is located

  Zip Code       Enter the zip code of the performance sit location

  Country        Enter the country of the performance site from the list
  -------------- -----------------------------------------------------------

> INSTRUCTIONS FOR R&R BUDGET

**Section A & B**

SECTION A

+-------------+--------------------------------------------------------+
| Field Name  | Instructions                                           |
+-------------+--------------------------------------------------------+
| Org         | Enter the DUNS or DUNS +4 number of your organization. |
| anizational | For applicants applying electronically, this field is  |
| DUNS        | pre-populated from the R&R SF424 Cover Page.           |
+-------------+--------------------------------------------------------+
| Budget Type | Check the appropriate block. Check Project if the      |
|             | budget requested is for the primary applicant          |
|             | organization. Check Subaward/consortium organizations  |
|             | ( if applicable). Separate budgets are usually         |
|             | required only for Subaward Budgets and are not allowed |
|             | by HRSA unless legislatively authorized or requested   |
|             | in the program application guidance. Use the R&R       |
|             | Subaward Budget Attachment and attach as a separate    |
|             | file on the R&R Budget Attachment(s) form..            |
+-------------+--------------------------------------------------------+
| Enter Name  | Enter the name of your organization                    |
| of          |                                                        |
| O           |                                                        |
| rganization |                                                        |
+-------------+--------------------------------------------------------+
| Start Date  | Enter the requested Start Date of Budget Period        |
+-------------+--------------------------------------------------------+
| End Date    | Enter the requested End Date of the Budget Period (    |
|             | these should cover 1 full year/12 months)              |
+-------------+--------------------------------------------------------+
| Budget      | Identify the specific budget period (1 for first year  |
| Period      | of the grant, 2 for second year of the grant, 3 for    |
|             | third etc.)                                            |
+-------------+--------------------------------------------------------+
| A.          | Enter the **Prefix**, F**irst/(Given) name**, **Middle |
|             | name** (if applicable), **Last Name** and **Suffix**   |
| Senior/Key  | of the senior/key person                               |
| Person      |                                                        |
+-------------+--------------------------------------------------------+
| Project     | Enter the project role of the Senior/Key person.       |
| Role        |                                                        |
+-------------+--------------------------------------------------------+
| Base Salary | Enter the annual compensation paid by the employer for |
| (\$)        | each Senior/Key person. This includes all activities   |
|             | such as research, teaching, patient care. etc.         |
+-------------+--------------------------------------------------------+
| Cal. Months | Enter the number of Calendar months devoted to the     |
|             | project in the applicable box for each project role    |
|             | category                                               |
+-------------+--------------------------------------------------------+
| Acad.       | Enter the number of academic year months devoted to    |
| Months      | the project in the applicable box for each project     |
|             | role category ( If your institution does not use a 9   |
|             | month academic period, indicate your institution's     |
|             | definition of academic year in the budget              |
|             | justification)                                         |
+-------------+--------------------------------------------------------+
| Sum. Months | Enter the number of summer months devoted to the       |
|             | project in the applicable box for each project role    |
|             | category ( If your institution does not use a 3 month  |
|             | summer period, indicate your institution's definition  |
|             | of summer period in the budget justification)          |
+-------------+--------------------------------------------------------+
| Requested   | Regardless of the number of months being devoted to    |
| Salary (\$) | the project, indicate only the funds being requested   |
|             | to cover the amount of salary/wages for each           |
|             | senior/key person for this budget period               |
+-------------+--------------------------------------------------------+
| Fringe      | Enter applicable fringe benefits, if any, for each     |
| Benefits    | senior/key person                                      |
| (\$)        |                                                        |
+-------------+--------------------------------------------------------+
| Funds       | Enter federal funds requested for salary/wages &       |
| Requested   | fringe benefits for each senior/key person for this    |
| (\$)        | budget period for this project.                        |
+-------------+--------------------------------------------------------+
| Line 9.     | Enter the total federal funds requested for all        |
| Total Funds | senior/key persons listed in the attached file (these  |
| Requested   | requested funds would be for key persons over and      |
| for all     | above those listed in the preceding rows/fields of     |
| Senior Key  | section A). If applicants are applying in hardcopy     |
| Persons in  | please attach a table listing the key personnel over   |
| the         | and above the 8 persons listed on the budget page      |
| attached    | using the same format appearing in the budget table    |
| Files       | and enter the total funds requested for these          |
|             | additional by people in row 9.                         |
+-------------+--------------------------------------------------------+
| Additional  | If applying electronically attach a file here          |
| Senior Key  | detailing the funds requested for key personnel over   |
| Persons     | and above the 8 senior/key persons already listed in   |
| (attach     | this section; include all pertinent budget             |
| file)       | information. The total funds requested in this file    |
|             | should be entered in "**the total funds requested for  |
|             | all additional senior/key persons in line 9 of Section |
|             | A** . If applying in hardcopy please be certain to     |
|             | provide detailed information on the key personnel as   |
|             | well as funds requested in the same format appearing   |
|             | in the budget table. Be certain to include the total   |
|             | funds for these additional key persons in **the total  |
|             | funds requested for all additional senior/key persons  |
|             | in line 9 of Section A.**                              |
+-------------+--------------------------------------------------------+

**SECTION B. Other Personnel**

  ------------- ---------------------------------------------------------
  Field Name    Instructions

  Number of     For each project role/category identify the number of
  Personnel     personnel proposed.

  Project Role  If project role is other than Post-Doctoral Associates,
                Graduate Students, Undergraduate students, or
                Secretarial/Clerical, enter the appropriate project role
                ( for example, Engineer, Statistician, IT Professional
                etc. ) in the blanks.

  Cal. Months   Enter the number of Calendar months devoted to the
                project in the applicable box for each project role
                category/stipend category

  Acad. Months  Enter the number of academic year months devoted to the
                project in the applicable box for each project role
                category ( If your institute does not use a 9 month
                academic period , indicate your institution's definition
                of academic year in the budget justification)

  Sum. Months   Enter the number of summer months devoted to the project
                in the applicable box for each project role category ( If
                your institute does not use a 3 month summer period ,
                indicate your institution's definition of summer period
                in the budget justification)

  Requested     Regardless of the number of months being devoted to the
  Salary (\$)   project, indicate only the amount of salary/wages/stipend
                amount being requested for each project role

  Fringe        Enter applicable fringe benefits, if any, for each
  Benefits (\$) project role category

  Funds         Enter requested salary/wages & fringe benefits for each
  Requested     project role category
  (\$)          

  Total Number  Enter the total number of other personnel and related
  Other         funds requested for this project
  Personnel     

  Total Salary, Enter the total funds requested for all senior key
  Wages and     persons, stipends and all other personnel- If applying
  Fringe        electronically this will be computed based on detailed
  Benefits (A   information provided. If applying through hard copy
  &B)           please enter this number, ensuring that the total is
                equal to the detailed information provided
  ------------- ---------------------------------------------------------

RESEARCH AND RELATED BUDGET

SECTION C, D, E,

**Section C, D & E**

SECTION C: Equipment Description

  ---------------- ---------------------------------------------------------
  Field Name       Instructions

  Organizational   Enter the DUNS or DUNS +4 number of your organization.
  DUNS             For Project applicants and those applying electronically,
                   this field is pre-populated from the R&R SF424 Cover
                   Page.

  Budget Type      Check the appropriate block. Check Project if the budget
                   requested is for the primary applicant organization.
                   Check Subaward/consortium organizations ( if applicable).
                   Separate budgets are usually required only for Subaward
                   Budgets and are not allowed by HRSA unless legislatively
                   authorized or requested in the program application
                   guidance. Use the R&R Subaward Budget Attachment and
                   attach as a separate file on the R&R Budget Attachment(s)
                   form)

  Enter Name of    Enter the name of your organization
  Organization     

  Start Date       Enter the requested Start Date of Budget Period

  End Date         Enter the requested/proposed End Date of the Budget
                   Period ( these should cover 1 full year/12 months)

  Budget Period    Identify the specific budget period (1 for first year of
                   the grant, 2 for second year of the grant, 3 for third
                   etc.)

  Equipment Item   Equipment is identified as an item of property that has
                   an acquisition cost of \$5,000 or more (unless the
                   organization has established lower levels) and an
                   expected service life of more than 1 year. List each item
                   of equipment separately and justify each in the budget
                   justification section. Ordinarily allowable items are
                   limited to those which will be used primarily or
                   exclusively in the actual conduct or performance of grant
                   activities.

  Funds Requested  Enter the estimated cost of each item of equipment,
                   including shipping and any maintenance costs and
                   agreements.

  Total Funds      Enter the estimated cost of all equipment listed in any
  Requested for    attached documents/files.
  all equipment    
  listed in the    
  attached files   

  Additional       If the space provided can not accommodate all the
  Equipment        equipment proposed, attach a file or document delineating
                   the equipment proposed. If applying in hardcopy please
                   provide this information on a separate/attached sheet.
                   List the total funds requested on line 11 of this
                   section.
  ---------------- ---------------------------------------------------------

**SECTION D. Travel**

  -------------- ---------------------------------------------------------
  Field Name     Instructions

  Domestic       Enter the total funds requested for domestic travel.
  Travel Costs   Domestic travel includes Canada, Mexico and US
  (Incl. Canada, possessions. In the budget justifications section,
  Mexico, and US include the purpose, destinations, dates of travel (if
  Possessions)   known), and number of individuals for each trip. If the
                 dates of travel are known, specify estimated length of
                 trip (for example, 3 days)

  Foreign Travel Enter the total funds to be used for foreign travel.
  Costs          Foreign travel includes any travel outside of the United
                 States, Canada, Mexico and or the U.S. Possessions. In
                 the budget justification section, include the purpose,
                 destination, travel dates (if known), and number of
                 individuals for each trip. If the dates of travel are not
                 known , specify estimated length of trip ( ex. 3 days)

  Total Travel   The total funds requested for all travel related to this
  Costs          project-- this should equal the total of all domestic and
                 foreign and may be computed if applying electronically.
                 If applying in hardcopy please enter this amount
  -------------- ---------------------------------------------------------

RESEARCH AND RELATED BUDGET

SECTION C, D, E,

**SECTION E: Participant/Trainee Support Costs**

  --------------------- -----------------------------------------------------
  Field Name            Instructions

  Tuition/Fees/Health   Enter the total amount of funds requested for
  Insurance             participant /trainee tuition, fees, and /or health
                        insurance. (if applicable)

  Stipends              Enter the total amount of funds requested for
                        participant /trainee stipends.

  Travel                Enter the total funds requested for
                        participant/trainee travel associated with this
                        project (if applicable)

  Subsistence           Enter the total funds requested for
                        participant/trainee subsistence (if applicable)

  Other                 Describe and enter the total funds requested for any
                        other participant/trainee costs/institutional
                        allowances, scholarships etc. Please identify these
                        in the space provided.

  Number of             Enter the total number of proposed
  Participants          participants/trainees (those receiving stipends,
                        scholarships, etc.)

  Trainee Costs         Enter the total costs associated with the above
                        categories (i.e. participants/trainees- items 1-5).
                        If applying electronically this total will be
                        calculated for you.
  --------------------- -----------------------------------------------------

RESEARCH AND RELATED BUDGET - SECTION F-K Budget Period

  ---------------- ---------------------------------------------------------
  Field Name       Instructions

  Organizational   Enter the DUNS or DUNS +4 number of your organization.
  DUNS             For Project applicants and those applying electronically,
                   this field is pre-populated from the R&R SF424 Cover
                   Page.

  Budget Type      Check the appropriate block. Check Project if the budget
                   requested is for the primary applicant organization.
                   Check Subaward/consortium organizations (if applicable).
                   Separate budgets are usually required only for Subaward
                   Budgets and are not allowed by HRSA unless legislatively
                   authorized or requested in the program application
                   guidance. Use the R&R Subaward Budget Attachment and
                   attach as a separate file on the R&R Budget Attachment(s)
                   form.

  Enter Name of    Enter the name of your organization
  Organization     

  Start Date       Enter the requested Start Date of the Budget Period

  End Date         Enter the requested/proposed End Date of the Budget
                   Period (these should cover 1 full year/12 months)

  Budget Period    Identify the specific budget period (1 for first year of
                   the grant, 2 for second year of the grant, 3 for third
                   etc.)
  ---------------- ---------------------------------------------------------

**SECTION F. Other Direct Cost**

+---------------------------+------------------------------------------+
| Field Name                | Instructions                             |
+---------------------------+------------------------------------------+
| 1\. Materials and         | Enter the total funds requested for      |
| Supplies                  | materials and supplies. In the budget    |
|                           | justification attachment please itemize  |
|                           | all categories for which costs exceed    |
|                           | \$1,000. Categories less than \$1,000 do |
|                           | not have to be itemized.                 |
+---------------------------+------------------------------------------+
| 2\. Publication Costs     | Enter the total publication funds        |
|                           | requested. The budget may request funds  |
|                           | for the cost of documenting, preparing,  |
|                           | publishing or otherwise disseminating    |
|                           | the findings of this project to others.  |
|                           | In the budget justification include      |
|                           | supporting information.                  |
+---------------------------+------------------------------------------+
| 3\. Consultant Services   | Enter the total funds requested for      |
|                           | consultant services. In the budget       |
|                           | justification identify each consultant,  |
|                           | the services to be performed, travel     |
|                           | related to this project and the total    |
|                           | estimated costs.                         |
+---------------------------+------------------------------------------+
| 4\. ADP/Computer Services | Enter total funds requested for          |
|                           | ADP/computer services. In the budget     |
|                           | justification include the established    |
|                           | computer service rates at the proposed   |
|                           | organization (if applicable)             |
+---------------------------+------------------------------------------+
| 5\. Subawards/Consortia/  | Enter total funds requested for          |
| Contractual Costs         | subaward, consortium and/or contractual  |
|                           | costs proposed for this project.         |
+---------------------------+------------------------------------------+
| 6\. Equipment/Facility    | Enter total funds requested for          |
|                           | equipment or facility rental or users    |
| Rental/ User Fees         | fees. In the budget justification please |
|                           | identify and justify these fees.         |
+---------------------------+------------------------------------------+
| 7\. Alterations and       | Enter the total funds requested for      |
| Renovations               | alterations and renovations. In the      |
|                           | budget justification itemize by category |
| (not applicable to        | and justify the costs including repairs, |
| training program grants)  | painting, removal or installation of     |
|                           | partitions. Where applicable provide     |
|                           | square footage and costs.                |
+---------------------------+------------------------------------------+
| Items 8-10                | In items 8-10 please describe any        |
|                           | "other" direct costs not requested       |
|                           | above. Use the Budget Justification      |
|                           | attachment to further itemize and        |
|                           | justify these costs. If line space is    |
|                           | inadequate please use line 10 to combine |
|                           | all remaining "other direct costs" and   |
|                           | include details of these costs in the    |
|                           | budget justification.                    |
+---------------------------+------------------------------------------+
| Total Other Costs         | The total funds requested for all Other  |
|                           | Direct Costs                             |
+---------------------------+------------------------------------------+

**SECTION G: Direct Costs**

**If applying electronically, this item will be computed as the sum of
sections A-F . If applying in paper please enter the sum of sections A-F
in this field**

**SECTION H: Indirect Costs**

  ----------------- -----------------------------------------------------
  Field Name        Instructions

  Indirect Cost     Indicate the type of indirect cost. Also indicate if
  Type              this is off-site. If more than one rate/base is
                    involved, use separate lines for each. If you do not
                    have a current indirect cost rate (s) approved by a
                    Federal Agency indicate "None---will negotiate" and
                    include information for proposed rate. Use the budget
                    justification if additional space is needed.

  Indirect Cost     Indicate the most recent indirect cost rate(s), also
  Rate (%)          known as Facilities and Administrative Costs {F&A}
                    established with a cognizant Federal office or, in
                    the case of for--profit organizations, the rate(s)
                    established with the appropriate agency. If you do
                    not have a cognizant oversight agency and are
                    selected for an award, you must submit your requested
                    indirect cost rate documentation to the awarding
                    department. For HHS this would be the Division of
                    Cost Allocation in DHHS.

  Indirect Cost     Enter amount of the base for each indirect cost type.
  Base (\$)         

  Funds Requested   Enter the total funds requested for each indirect
                    cost type.

  Cognizant Federal Enter the name of the cognizant Federal Agency, name
  Agency            and telephone number of the individual responsible
                    for negotiating your rate. If no cognizant agency is
                    known, enter None.
  ----------------- -----------------------------------------------------

**SECTION I: Total Direct and Indirect Institutional Costs (Section G+
Section H)**

Enter the total funds requested for direct and indirect costs. If
applying electronically, this field will be calculated for you.

**SECTION J: Fee**

Generally, a fee is not allowed on a grant or cooperative agreement. Do
not include a fee in your budget, unless the program announcement
specifically allows the inclusion of a fee. If a fee is allowable, enter
the fee requested in this field.

**SECTION K: Budget Justification**

Detailed instructions for information to include in this section will be
provided in the program application guidance. Use the budget
justification to provide the additional information in each budget
category and any other information necessary to support your budget
request. Please use this attachment/section to provide the information
requested/required in the program guidance. Please refer to the guidance
to determine the need for and placement of (ex. in Appendix section) any
other required budget tables stipulated in the guidance.

RESEARCH AND RELATED BUDGET --CUMULATIVE BUDGET

If applying electronically, all of the values on this form will be
calculated based on the amounts that were entered previously under
sections A through K for each of the individual budget periods.
Therefore, if this application is being submitted electronically no data
entry is allowed or required in order to complete this Cumulative Budget
section.

If any amounts displayed on this form appear to be incorrect you may
correct the value by adjusting one or more of the values that
contributed to the total from the previous sections. To make such an
adjustment you will need to revisit the appropriate budget period
form(s) to enter corrected values.

If applying in paper form please ensure that entries in the cumulative
budget are consistent with those entered in Sections A-K.

+-----------------+----------------------------------------------------+
| Field Name      | Instructions                                       |
+-----------------+----------------------------------------------------+
| **Section A:**  | The cumulative total funds requested for all       |
| **Senior/Key    | Senior/Key personnel.                              |
| Person**        |                                                    |
+-----------------+----------------------------------------------------+
| **Section B:**  | The cumulative total funds requested for all other |
|                 | personnel.                                         |
| **Other         |                                                    |
| Personnel**     |                                                    |
+-----------------+----------------------------------------------------+
| Total Number    | The cumulative total number of other personnel.    |
| Other Personnel |                                                    |
+-----------------+----------------------------------------------------+
| Total Salary,   | The cumulative total funds requested for all       |
| Wages, and      | Senior/Key personnel and all other personnel.      |
| Fringe Benefits |                                                    |
| (Section A +    |                                                    |
| Section B)      |                                                    |
+-----------------+----------------------------------------------------+
| **Section C:    | The cumulative total funds requested for all       |
| Equipment**     | equipment.                                         |
+-----------------+----------------------------------------------------+
| **Section D:**  | The cumulative total funds requested for all       |
|                 | travel.                                            |
| **Travel**      |                                                    |
+-----------------+----------------------------------------------------+
| 1\. Domestic    | The cumulative total funds requested for all       |
|                 | domestic travel.                                   |
+-----------------+----------------------------------------------------+
| 2\. Foreign     | The cumulative total funds requested for all       |
|                 | foreign travel.                                    |
+-----------------+----------------------------------------------------+
| **Section E:    | The cumulative total funds requested for all       |
| Part            | participant/trainee costs.                         |
| icipant/Trainee |                                                    |
| Support Costs** |                                                    |
+-----------------+----------------------------------------------------+
| 1\.             | Enter the number of Calendar months devoted to the |
| Tuit            | project in the applicable box for each project     |
| ion/Fees/Health | role category.                                     |
| Insurance       |                                                    |
+-----------------+----------------------------------------------------+
| 2\. Stipends    | Enter the cumulative total funds requested for     |
|                 | participants/trainee stipends.                     |
+-----------------+----------------------------------------------------+
| 3\. Travel      | The cumulative total funds requested for Trainee   |
|                 | /Participant travel.                               |
+-----------------+----------------------------------------------------+
| 4\. Subsistence | The cumulative total funds requested for           |
|                 | Trainee/Participant subsistence.                   |
+-----------------+----------------------------------------------------+
| 5\. Other       | The cumulative total funds requested for any Other |
|                 | participant trainee costs including scholarships.  |
+-----------------+----------------------------------------------------+
| 6\. Number of   | The cumulative total number of proposed            |
| partic          | participants/trainees.                             |
| ipants/trainees |                                                    |
+-----------------+----------------------------------------------------+
| **Section F:    | The cumulative total funds requested for all other |
| Other Direct    | direct costs.                                      |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| 1\. Materials   | The cumulative total funds requested for Materials |
| and Supplies    | and Supplies.                                      |
+-----------------+----------------------------------------------------+
| 2\. Publication | The cumulative total funds requested for           |
| Costs           | Publications.                                      |
+-----------------+----------------------------------------------------+
| 3\. Consultant  | The cumulative total funds requested for           |
| Services        | Consultant Services.                               |
+-----------------+----------------------------------------------------+
| 4\.             | The cumulative total funds requested for           |
| ADP/Computer    | ADP/Computer Services.                             |
| Services        |                                                    |
+-----------------+----------------------------------------------------+
| 5\. Subawards/  | The cumulative total funds requested for 1) all    |
| Consortium/     | subaward/ consortium organization(s) proposed for  |
| Contractual     | the project, and 2) any other contractual costs    |
| Costs           | proposed for the project.                          |
+-----------------+----------------------------------------------------+
| 6\. Equipment   | The cumulative total funds requested for Equipment |
| or Facility     | or Facility Rental/ User Fees.                     |
| Rental/User     |                                                    |
| Fees            |                                                    |
+-----------------+----------------------------------------------------+
| 7\. Alterations | The cumulative total funds requested for           |
| and Renovations | Alterations and Renovations.                       |
+-----------------+----------------------------------------------------+
| 8\. Other 1     | The cumulative total funds requested in line 8 or  |
|                 | the first Other Direct Costs category.             |
+-----------------+----------------------------------------------------+
| 9\. Other 2     | The cumulative total funds requested in line 9or   |
|                 | the second Other Direct Costs category.            |
+-----------------+----------------------------------------------------+
| 10\. Other 3    | The cumulative total funds requested in line 10 or |
|                 | the third Other Direct Costs category.             |
+-----------------+----------------------------------------------------+
| **Section G:    | The cumulative total funds requested for all       |
| Direct Costs    | direct costs.                                      |
| A-F**           |                                                    |
+-----------------+----------------------------------------------------+
| **Section H:    | The cumulative total funds requested for all       |
| Indirect        | indirect costs.                                    |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| **Section I :   | The cumulative total funds requested for direct    |
| Total Direct    | and indirect costs.                                |
| and Indirect    |                                                    |
| Costs**         |                                                    |
+-----------------+----------------------------------------------------+
| **Section J:    | The cumulative funds requested for Fees (if        |
| Fee**           | applicable).                                       |
+-----------------+----------------------------------------------------+

INSTRUCTIONS FOR R&R SUBAWARD BUDGET ATTACHMENT(s) FORM

Subawards are not allowed by HRSA unless legislatively authorized or
requested in the Program Application Guidance. Please click on the
subaward budget attachment to obtain the required budget forms. Attach
all budget information by attaching the files in line items 1-10.

SF 424 R&R ASSURANCES

Read the 424 R&R Assurances in the program guidance. Signing of the
application FACE Page and sending the signed face page to the Grants
Application Center (see guidance) indicates acceptance of these
Assurances listed.

SF 424 R&R OTHER PROJECT INFORMATION COMPONENT

**SF 424 R&R Other Project Information:**

**If this is an application for a Research Grant Please Respond to All
of the Questions on this page.**

**If this is an application for a Training Grant Please Respond to Items
1 and Items 6-11.**

+----------------+-----------------------------------------------------+
| Field Name     | Instructions                                        |
+----------------+-----------------------------------------------------+
| 1\. Are Human  | If activities involving human subjects are planned  |
| Subjects       | at any time during proposed project check YES.      |
| Involved       | Check this box even if the proposed project is      |
|                | exempt from Regulations for the protection of Human |
|                | Subjects. Check NO if this is a training grant or   |
|                | if no activities involving human subjects are       |
|                | planned and skip to step 2.                         |
+----------------+-----------------------------------------------------+
| 1.a If YES to  | Skip this section if the answer to the previous     |
| Human Subjects | question was NO. If the answer was YES, indicate if |
| Involved       | the IRB review is pending. If IRB has been approved |
|                | enter the approval date. If exempt from IRB         |
|                | approval enter the exemption numbers corresponding  |
|                | to one or more of the exemption categories. See:    |
|                | http://ohrp                                         |
|                | .osophs.dhhs.gov/humansubjects/guidance/45cfr46.htm |
|                | for a list of the six categories of research that   |
|                | qualify for exemption from coverage by the          |
|                | regulations are defined in the Common Rule for the  |
|                | Protection of Human Subjects.                       |
|                |                                                     |
|                | For Human Subject Assurance Number enter the IRB    |
|                | approval number OR the approved Federal Wide        |
|                | Assurance ( FWA) , multiple project assurance (MPA) |
|                | , Single Project Assurance(SPA) Number or           |
|                | Cooperative Project Assurance Number that the       |
|                | applicant has on file with the Office of Human      |
|                | Research Protections, if available.                 |
+----------------+-----------------------------------------------------+
| 2\. Are        | If activities using vertebrae animals are planned   |
| Vertebrae      | at any time during the proposed project at any      |
| Animals Used   | performance site check the YES box; otherwise check |
|                | NO and proceed to step 3.                           |
+----------------+-----------------------------------------------------+
| 2 a. If YES to | Indicate if the IACUC review is pending by checking |
| Vertebrae      | YES in this field otherwise check NO. Enter the     |
| animals        | IACUC approval Date in the approval date field      |
|                | leave blank if approval is pending.                 |
|                |                                                     |
|                | For Animal Welfare Assurance Number , enter the     |
|                | Federally approved assurance number if available    |
+----------------+-----------------------------------------------------+
| 3\. Is         | Patentable ideas, trade secrets, privileged or      |
| Proprietary    | confidential commercial or financial information,   |
| /Privileged    | disclosure of which may harm the applicant, should  |
| Information    | be included in the application only when such       |
| Included in    | information is necessary to convey an understanding |
| the            | of the proposed project. If the application         |
| Application    | includes such information, check the YES box and    |
|                | clearly mark each line or paragraph of the pages    |
|                | containing proprietary/privileged information with  |
|                | a legend similar to: "the following contains        |
|                | proprietary /privileged information that (name of   |
|                | applicant) requests not be released to persons      |
|                | outside the Government, except for purposes of      |
|                | review and evaluation.                              |
+----------------+-----------------------------------------------------+
| 4a. Does this  | If your project will have an actual or potential    |
| project have   | impact on the environment check the YES box and     |
| an actual or   | explain in the box provided in **4b.** Otherwise    |
| potential      | check NO and proceed to question 5a.                |
| impact on the  |                                                     |
| environment?   |                                                     |
+----------------+-----------------------------------------------------+
| 4b. If yes,    | If you checked the YES box indicating an actual or  |
| please explain | potential impact on the environment, enter the      |
|                | explanation or the actual or potential impact on    |
|                | the environment here.                               |
+----------------+-----------------------------------------------------+
| 4c. If this    | If an exemption has been authorized or an EA or EIS |
| project has an | has been performed check the YES box in 4d.         |
| actual or      | Otherwise check the NO box.                         |
| potential      |                                                     |
| impact on the  |                                                     |
| environment    |                                                     |
| has an         |                                                     |
| exemption been |                                                     |
| authorized or  |                                                     |
| an             |                                                     |
| Environmental  |                                                     |
| Assessment     |                                                     |
| (EA) or an     |                                                     |
| Environmental  |                                                     |
| Impact         |                                                     |
| Statement      |                                                     |
| (EIS) been     |                                                     |
| performed?     |                                                     |
+----------------+-----------------------------------------------------+
| 4d. If yes     | If you checked the YES box indicating an exemption  |
| please explain | has been authorized or an EA or EIS has been        |
|                | performed, enter the explanation.                   |
+----------------+-----------------------------------------------------+
| 5a. Does the   | If your project involves activities outside of the  |
| project        | U.S. or partnerships with international             |
| involve        | collaborators check the YES box and list the        |
| activities     | countries in the box provided in 5b and an optional |
| outside of the | explanation in box 5c. Otherwise check NO and       |
| U.S. or        | proceed to item 6.                                  |
| partnership    |                                                     |
| with           |                                                     |
| international  |                                                     |
| collaborators? |                                                     |
+----------------+-----------------------------------------------------+
| 5b. If yes     | If the answer to 5a is YES -- identify the          |
| Identify       | countries with which international cooperative      |
| Countries      | activities are involved.                            |
+----------------+-----------------------------------------------------+
| 5c. Optional   | Use this box to provide any supplemental            |
| explanation    | information, if necessary. If necessary you can     |
|                | provide the information as an attachment by         |
|                | clicking "Add Attachment" to the right of Item 11   |
|                | below.                                              |
+----------------+-----------------------------------------------------+
| 6\. Project    | Please refer to the guidance for instructions       |
| Summary/       | regarding the information to include in the project |
| Abstract       | summary/abstract. The project summary must contain  |
|                | a summary of the proposed activity suitable for     |
|                | dissemination to the public. It should be a         |
|                | self-contained description of the project and       |
|                | should contain a statement of the objectives and    |
|                | methods employed. The summary must NOT include any  |
|                | proprietary/confidential information.               |
|                |                                                     |
|                | If applying electronically attach the               |
|                | summary/abstract by clicking on "Add Attachment"    |
|                | and browse to where you saved the file on your      |
|                | computer and attach.                                |
+----------------+-----------------------------------------------------+
| 7\. Project    | Provide the project narrative in accordance with    |
| Narrative      | the program guidance/announcement and/or            |
|                | agency/program specific instructions. If you are    |
|                | applying electronically, to attach project          |
|                | narrative click "Add Attachment," browse to where   |
|                | you saved the file, select the file, and click to   |
|                | attach. .                                           |
+----------------+-----------------------------------------------------+
| 8\.            | Provide a bibliography of any references cited in   |
| Bibliography   | the Project Narrative. Each reference must include  |
| and References | the names of all authors (in the sequence in which  |
| Cited          | they appear in the publication), the article and    |
|                | journal title, book title, volume number, page      |
|                | numbers and year of publication. Include only       |
|                | bibliographic citations. Be especially careful to   |
|                | follow scholarly practices in providing citations   |
|                | for source materials relied upon when preparing any |
|                | section of this application. If applying            |
|                | electronically -- attach the bibliography by        |
|                | clicking "Add Attachment" on line 8.                |
+----------------+-----------------------------------------------------+
| 9\. Facilities | This information is used to assess the capability   |
| and Other      | of the organizational resources available to        |
| Resources      | perform the effort proposed. Identify the           |
|                | facilities to be used (Laboratory, Animal,          |
|                | Computer, Office, Clinical and Other). If           |
|                | appropriate, indicate their pertinent capabilities, |
|                | relative proximity and extent of availability to    |
|                | the project (e.g. machine shop, electronic shop),   |
|                | and the extent to which they would be available to  |
|                | the project.                                        |
|                |                                                     |
|                | To attach a Facilities and Other Resources file,    |
|                | click Add Attachment, browse to where you saved the |
|                | file, select the file and then click open.          |
+----------------+-----------------------------------------------------+
| 10\. Equipment | List major items of equipment already available for |
|                | this project and if appropriate identify location   |
|                | pertinent and capabilities. To attach an Equipment  |
|                | file click "Add Attachment "and select the file to  |
|                | be attached.                                        |
+----------------+-----------------------------------------------------+
| 11\. Other     | Attach a file to provide any program specific forms |
| Attachments    | or requirements not provided elsewhere in the       |
|                | application in accordance with the agency or        |
|                | program specific guidance. Click "Add Attachment"   |
|                | and select the file for attachment from where you   |
|                | saved the file.                                     |
+----------------+-----------------------------------------------------+

ATTACHMENTS FORM

Use this form to add files/attachments required in the program guidance
whose location has not been specified elsewhere in the application
package. Use the first line item to attach the file with information on
your organization's Business Official. Name this file BUSINESS OFFICIAL
INFORMATION. Attach other files as required in the program guidance.

**Appendix D: Sample Forms**

> **Biographical Sketch** (also available at:
> <http://grants1.nih.gov/grants/funding/424/SF424R-R_biosketch.doc> )
>
> **Targeted/Planned Enrollment Table** (also available at:
> <http://grants1.nih.gov/grants/funding/424/SF424R-R_enrollment.doc> )
>
> **Inclusion Enrollment Report** (also available at:
> <http://grants1.nih.gov/grants/funding/424/SF424R-R_enrollmentreport.doc>
> )
>
> **Additional Senior/Key Person Profile(s)** (also available at:
> <http://grants1.nih.gov/grants/funding/424/SF424R-R_AdditionalProfiles.doc>
> )
>
> **Additional Location(s) for the Project/Performance Site Locations**
> (also available at:
> <http://grants1.nih.gov/grants/funding/424/SF424R-R_AdditionalLocations.doc>
> )

+---------------------------------+---+-------+--------+-----------------+
| **BIOGRAPHICAL SKETCH**         |   |       |        |                 |
|                                 |   |       |        |                 |
| Provide the following           |   |       |        |                 |
| information for the key         |   |       |        |                 |
| personnel and other significant |   |       |        |                 |
| contributors.\                  |   |       |        |                 |
| Follow this format for each     |   |       |        |                 |
| person. **DO NOT EXCEED FOUR    |   |       |        |                 |
| PAGES.**                        |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
| NAME                            |   | POS   |        |                 |
|                                 |   | ITION |        |                 |
|                                 |   | TITLE |        |                 |
+---------------------------------+---+-------+--------+-----------------+
| eRA COMMONS USER NAME           |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
| EDUCATION/TRAINING (*Begin with |   |       |        |                 |
| baccalaureate or other initial  |   |       |        |                 |
| professional education, such as |   |       |        |                 |
| nursing, and include            |   |       |        |                 |
| postdoctoral training.)*        |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
| INSTITUTION AND LOCATION        | D |       | Y      | FIELD OF STUDY  |
|                                 | E |       | EAR(s) |                 |
|                                 | G |       |        |                 |
|                                 | R |       |        |                 |
|                                 | E |       |        |                 |
|                                 | E |       |        |                 |
|                                 |   |       |        |                 |
|                                 | * |       |        |                 |
|                                 | ( |       |        |                 |
|                                 | i |       |        |                 |
|                                 | f |       |        |                 |
|                                 | a |       |        |                 |
|                                 | p |       |        |                 |
|                                 | p |       |        |                 |
|                                 | l |       |        |                 |
|                                 | i |       |        |                 |
|                                 | c |       |        |                 |
|                                 | a |       |        |                 |
|                                 | b |       |        |                 |
|                                 | l |       |        |                 |
|                                 | e |       |        |                 |
|                                 | ) |       |        |                 |
|                                 | * |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+
|                                 |   |       |        |                 |
+---------------------------------+---+-------+--------+-----------------+

Please refer to the application instructions in order to complete
sections A, B, and C of the Biographical Sketch.

+-------+---------+----------------------+--------+--------+--------+
| #     |         |                      |        |        |        |
| # Tar |         |                      |        |        |        |
| geted |         |                      |        |        |        |
| /Plan |         |                      |        |        |        |
| ned E |         |                      |        |        |        |
| nroll |         |                      |        |        |        |
| ment  |         |                      |        |        |        |
| Table |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| # Th  |         |                      |        |        |        |
| is re |         |                      |        |        |        |
| port  |         |                      |        |        |        |
| forma |         |                      |        |        |        |
| t sho |         |                      |        |        |        |
| uld N |         |                      |        |        |        |
| OT be |         |                      |        |        |        |
|  used |         |                      |        |        |        |
|  for  |         |                      |        |        |        |
| data  |         |                      |        |        |        |
| colle |         |                      |        |        |        |
| ction |         |                      |        |        |        |
|  from |         |                      |        |        |        |
|  stud |         |                      |        |        |        |
| y par |         |                      |        |        |        |
| ticip |         |                      |        |        |        |
| ants. |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Study |         |                      |        |        |        |
| T     |         |                      |        |        |        |
| itle: |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Total |         |                      |        |        |        |
| Pl    |         |                      |        |        |        |
| anned |         |                      |        |        |        |
| E     |         |                      |        |        |        |
| nroll |         |                      |        |        |        |
| ment: |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
|       |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| T     |         |                      |        |        |        |
| ARGET |         |                      |        |        |        |
| ED/PL |         |                      |        |        |        |
| ANNED |         |                      |        |        |        |
| E     |         |                      |        |        |        |
| NROLL |         |                      |        |        |        |
| MENT: |         |                      |        |        |        |
| N     |         |                      |        |        |        |
| umber |         |                      |        |        |        |
| of    |         |                      |        |        |        |
| Sub   |         |                      |        |        |        |
| jects |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| E     |         |                      | Sex/   |        |        |
| thnic |         |                      | Gender |        |        |
| Cat   |         |                      |        |        |        |
| egory |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
|       |         |                      | F      | Males  | Total  |
|       |         |                      | emales |        |        |
+-------+---------+----------------------+--------+--------+--------+
| His   |         |                      |        |        |        |
| panic |         |                      |        |        |        |
| or    |         |                      |        |        |        |
| L     |         |                      |        |        |        |
| atino |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Not   |         |                      |        |        |        |
| His   |         |                      |        |        |        |
| panic |         |                      |        |        |        |
| or    |         |                      |        |        |        |
| L     |         |                      |        |        |        |
| atino |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| E     |         |                      |        |        |        |
| thnic |         |                      |        |        |        |
| Cate  |         |                      |        |        |        |
| gory: |         |                      |        |        |        |
| Total |         |                      |        |        |        |
| of    |         |                      |        |        |        |
| All   |         |                      |        |        |        |
| Sub   |         |                      |        |        |        |
| jects |         |                      |        |        |        |
| \*    |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| R     |         |                      |        |        |        |
| acial |         |                      |        |        |        |
| Categ |         |                      |        |        |        |
| ories |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Ame   |         |                      |        |        |        |
| rican |         |                      |        |        |        |
| Ind   |         |                      |        |        |        |
| ian/A |         |                      |        |        |        |
| laska |         |                      |        |        |        |
| N     |         |                      |        |        |        |
| ative |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Asian |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| N     |         |                      |        |        |        |
| ative |         |                      |        |        |        |
| Haw   |         |                      |        |        |        |
| aiian |         |                      |        |        |        |
| or    |         |                      |        |        |        |
| Other |         |                      |        |        |        |
| Pa    |         |                      |        |        |        |
| cific |         |                      |        |        |        |
| Isl   |         |                      |        |        |        |
| ander |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| Black |         |                      |        |        |        |
| or    |         |                      |        |        |        |
| Af    |         |                      |        |        |        |
| rican |         |                      |        |        |        |
| Ame   |         |                      |        |        |        |
| rican |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| White |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| R     |         |                      |        |        |        |
| acial |         |                      |        |        |        |
| C     |         |                      |        |        |        |
| atego |         |                      |        |        |        |
| ries: |         |                      |        |        |        |
| Total |         |                      |        |        |        |
| of    |         |                      |        |        |        |
| All   |         |                      |        |        |        |
| Sub   |         |                      |        |        |        |
| jects |         |                      |        |        |        |
| \*    |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+
| \*    |         |                      |        |        |        |
| The   |         |                      |        |        |        |
| "E    |         |                      |        |        |        |
| thnic |         |                      |        |        |        |
| Cate  |         |                      |        |        |        |
| gory: |         |                      |        |        |        |
| Total |         |                      |        |        |        |
| of    |         |                      |        |        |        |
| All   |         |                      |        |        |        |
| Subj  |         |                      |        |        |        |
| ects" |         |                      |        |        |        |
| must  |         |                      |        |        |        |
| be    |         |                      |        |        |        |
| equal |         |                      |        |        |        |
| to    |         |                      |        |        |        |
| the   |         |                      |        |        |        |
| "R    |         |                      |        |        |        |
| acial |         |                      |        |        |        |
| C     |         |                      |        |        |        |
| atego |         |                      |        |        |        |
| ries: |         |                      |        |        |        |
| Total |         |                      |        |        |        |
| of    |         |                      |        |        |        |
| All   |         |                      |        |        |        |
| Subje |         |                      |        |        |        |
| cts." |         |                      |        |        |        |
+-------+---------+----------------------+--------+--------+--------+

<table>
<colgroup>
<col style="width: 17%" />
<col style="width: 28%" />
<col style="width: 4%" />
<col style="width: 0%" />
<col style="width: 7%" />
<col style="width: 0%" />
<col style="width: 9%" />
<col style="width: 1%" />
<col style="width: 0%" />
<col style="width: 13%" />
<col style="width: 0%" />
<col style="width: 12%" />
<col style="width: 0%" />
<col style="width: 5%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="14"><h2 id="inclusion-enrollment-report">Inclusion
Enrollment Report</h2></td>
</tr>
<tr class="even">
<td colspan="14"><h1
id="this-report-format-should-not-be-used-for-data-collection-from-study-participants.-1">This
report format should NOT be used for data collection from study
participants.</h1></td>
</tr>
<tr class="odd">
<td>Study Title:</td>
<td colspan="13"></td>
</tr>
<tr class="even">
<td>Total Enrollment:</td>
<td colspan="3"></td>
<td colspan="3">Protocol Number:</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td>Grant Number:</td>
<td colspan="2"></td>
<td colspan="11"></td>
</tr>
<tr class="even">
<td colspan="14"></td>
</tr>
<tr class="odd">
<td colspan="14">PART A. TOTAL ENROLLMENT REPORT: Number of Subjects
Enrolled to Date (Cumulative)<br />
by Ethnicity and Race</td>
</tr>
<tr class="even">
<td colspan="2" rowspan="2">Ethnic Category</td>
<td colspan="12">Sex/Gender</td>
</tr>
<tr class="odd">
<td colspan="4">Females</td>
<td colspan="3">Males</td>
<td colspan="2">Unknown or Not Reported</td>
<td colspan="3">Total</td>
</tr>
<tr class="even">
<td colspan="2">Hispanic or Latino</td>
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>**</td>
</tr>
<tr class="odd">
<td colspan="2">Not Hispanic or Latino</td>
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="even">
<td colspan="2">Unknown (individuals not reporting ethnicity)</td>
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Ethnic Category: Total of All Subjects*</td>
<td colspan="4"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td>*</td>
</tr>
<tr class="even">
<td colspan="2">Racial Categories</td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="2">American Indian/Alaska Native</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Asian</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Native Hawaiian or Other Pacific Islander</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Black or African American</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">White</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">More Than One Race</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Unknown or Not Reported</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Racial Categories: Total of All Subjects*</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">*</td>
</tr>
<tr class="odd">
<td colspan="14"></td>
</tr>
<tr class="even">
<td colspan="14">PART B. HISPANIC ENROLLMENT REPORT: Number of Hispanics
or Latinos Enrolled to Date (Cumulative)</td>
</tr>
<tr class="odd">
<td colspan="2">Racial Categories</td>
<td colspan="3">Females</td>
<td colspan="3">Males</td>
<td colspan="2">Unknown or Not Reported</td>
<td colspan="4">Total</td>
</tr>
<tr class="even">
<td colspan="2">American Indian or Alaska Native</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Asian</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Native Hawaiian or Other Pacific Islander</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Black or African American</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">White</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">More Than One Race</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="2">Unknown or Not Reported</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2"></td>
</tr>
<tr class="odd">
<td colspan="2">Racial Categories: Total of Hispanics or Latinos**</td>
<td colspan="3"></td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="2"></td>
<td colspan="2">**</td>
</tr>
<tr class="even">
<td colspan="14"><p>* These totals must agree.</p>
<p>** These totals must agree.</p></td>
</tr>
</tbody>
</table>

To list Additional Senior/Key Person Profile(s) for the Senior/Key
Person Profile(s) Component, use the format provided below. You can copy
the informational table as many times as needed, or delete tables that
are not needed. Follow the instructions provided for Senior/Key Person
\[*n*\] Profile, indicating the number of the profile. You must enter
the Prefix, Suffix, State, Country, and Project Role, rather than
selecting from a list.

Please delete these instructions before attaching this file to your
Senior/Key Person Profile(s) Component.

  ----------------- --------- -- -- -- -- -- -- ----- -- --- -------- ------- ----------- ------------- ---- -- -------- -- -- ------------ -- ----------- --------
  PROFILE --                                                                                                                                               
  Senior/Key Person                                                                                                                                        

  Prefix            \*First                                  Middle                                             \*Last                                     Suffix
                    Name                                     Name                                               Name                                       

                                                                                                                                                           

  Position/Title:                                                                         Department:                                                      

  Organization                                                                                                                                             
  Name:                                                                                                                                                    

  Division:                                                                                                                                                

  \*Street1:                                                                              Street2:                                                         

  \*City:                                                                                 County:                                                          

  \*State:                                                            \*Zip                                                    \*Country:                  
                                                                      Code:                                                                                

  \*Phone Number:                                                                         Fax Number:                                                      

  \*E-Mail:                                                                                                                                                

  Credential, e.g.,                                                                                                                                        
  agency login:                                                                                                                                            

  \*Project Role:                                                             Other                                                                        
                                                                              Project                                                                      
                                                                              Role                                                                         
                                                                              Category:                                                                    
  ----------------- --------- -- -- -- -- -- -- ----- -- --- -------- ------- ----------- ------------- ---- -- -------- -- -- ------------ -- ----------- --------

  ----------------- --------- -- -- -- -- -- -- ----- -- --- -------- ------- ----------- ------------- ---- -- -------- -- -- ------------ -- ----------- --------
  PROFILE --                                                                                                                                               
  Senior/Key Person                                                                                                                                        

  Prefix            \*First                                  Middle                                             \*Last                                     Suffix
                    Name                                     Name                                               Name                                       

                                                                                                                                                           

  Position/Title:                                                                         Department:                                                      

  Organization                                                                                                                                             
  Name:                                                                                                                                                    

  Division:                                                                                                                                                

  \*Street1:                                                                              Street2:                                                         

  \*City:                                                                                 County:                                                          

  \*State:                                                            \*Zip                                                    \*Country:                  
                                                                      Code:                                                                                

  \*Phone Number:                                                                         Fax Number:                                                      

  \*E-Mail:                                                                                                                                                

  Credential, e.g.,                                                                                                                                        
  agency login:                                                                                                                                            

  \*Project Role:                                                             Other                                                                        
                                                                              Project                                                                      
                                                                              Role                                                                         
                                                                              Category:                                                                    
  ----------------- --------- -- -- -- -- -- -- ----- -- --- -------- ------- ----------- ------------- ---- -- -------- -- -- ------------ -- ----------- --------

To list Additional Location(s) for the Project/Performance Site
Locations Component, use the format provided below. You can copy the
informational table as many times as needed, or delete tables that are
not needed. Follow the instructions provided for Project/Performance
Site Locations, except you must enter the Site Location number, and
enter the State and Country rather than selecting from a list.

Please delete these instructions before attaching this file to your
Project/Performance Site Locations Component.

  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------
  Project/Performance                                                                    
  Site Location                                                                          

  Organization Name:                                                                     

  \*Street1:                                                                             

  Street2:                                                                               

  \*City:                                                      County:                   

  \*State:                                       \*ZIP                      \*Country:   
                                                 Code:                                   
  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------

  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------
  Project/Performance                                                                    
  Site Location                                                                          

  Organization Name:                                                                     

  \*Street1:                                                                             

  Street2:                                                                               

  \*City:                                                      County:                   

  \*State:                                       \*ZIP                      \*Country:   
                                                 Code:                                   
  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------

  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------
  Project/Performance                                                                    
  Site Location                                                                          

  Organization Name:                                                                     

  \*Street1:                                                                             

  Street2:                                                                               

  \*City:                                                      County:                   

  \*State:                                       \*ZIP                      \*Country:   
                                                 Code:                                   
  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------

  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------
  Project/Performance                                                                    
  Site Location                                                                          

  Organization Name:                                                                     

  \*Street1:                                                                             

  Street2:                                                                               

  \*City:                                                      County:                   

  \*State:                                       \*ZIP                      \*Country:   
                                                 Code:                                   
  --------------------- -- ------ -------- ----- -------- ---- --------- -- ------------ -------------

Appendix E

**MATERNAL AND CHILD HEALTH BUREAU (MCHB)**

**STRATEGIC RESEARCH ISSUES: Fiscal Years (FYs) 2004---2009**

+-----------------------------------------------------------------------+
| **Strategic Research Issue #I. Public health service systems and      |
| infrastructures at the community, State and/or national levels, as    |
| they apply to different maternal and child health (MCH) populations   |
| ^(1)^ based on demographic\*, epidemiological, and/or other           |
| factors\*\*.**                                                        |
|                                                                       |
| **(Correlates to MCHB Strategic Plan: FYs 2003-2007,**                |
|                                                                       |
| **Goal 4: Improve the Health Infrastructure and Systems of Care.)**   |
|                                                                       |
| > **\*Demographic factors may include age and developmental status,   |
| > gender, race/ethnicity, geography, economic status, etc.**          |
| >                                                                     |
| > **\*\* Other factors may include legislation, policies, etc that    |
| > may influence availability and access to specific services.**       |
+-----------------------------------------------------------------------+

**IMPORTANT:** To assist the reader in better understanding what is
meant by MCHB Strategic Research Issue #I, the following are examples of
possible areas of study addressing this issue. **[They are only examples
for illustrative purposes and do not constitute preferences for funding
consideration]{.underline}**. The Bureau strongly encourages research
studies that specifically address issues related to MCHB investments and
programs.

-   **Effectiveness of Screening Programs for Women:** Study the
    individual, system, and community factors associated with screening
    and assessment programs that lead to referral and utilization of
    intervention for risk factors such as substance abuse and other
    conditions (e.g., obesity, diabetes) that may affect health outcomes
    for women and/or their children.

-   **Integrated systems of care specifically identified in Title V
    legislation for Children with Special Health Care Needs (CSHCN)
    ^(2)^:** Determine the impact of **Care Coordination** ^(3)^
    provided in the medical home and other settings on child and family
    outcomes for CSHCN.

-   Study public-private partnership models for provision of services,
    such as public health provision of "wrap around" or "enabling"
    services, and their overall relative efficacy and compared with
    private practice or public clinic only.

-   Investigate the processes involved in the **transition of
    adolescents** with special health care needs to adult health care,
    particularly the role of State health systems in facilitating or
    hindering transitions.

-   Investigate the effects of the organization and delivery of
    comprehensive, continuous services on the health status and services
    utilization of children/adolescents, including those with special
    health care needs and those vulnerable for poor psychosocial
    outcomes (e.g., children/youth in foster care, involved with the
    juvenile justice system, or who are homeless).

-   Assess the impact of integration of newborn screening program (NBS)
    on other MCH programs and enhanced data sharing at the State level
    and evaluate if screened children have access to **medical homes**
    ^(4)^.

-   Assess emerging research in the prevention of dental caries in
    pregnant women and its effects on their children through the use of
    oral rinse and varnish, chlorhexidine, xylitol, and/or iodine.

+-----------------------------------------------------------------------+
| **Strategic Research Issue #II. MCH services and systems of care      |
| efforts to eliminate health disparities and barriers to health care   |
| access for MCH populations. These health disparities and barriers to  |
| health care access may include racial/ethnic, cultural, linguistic,   |
| gender, developmental, geographic, immigrant, underserved, economic   |
| considerations, etc.**                                                |
|                                                                       |
| **(Correlates to MCHB Strategic Plan: FYs 2003-2007, Goal 3:          |
| Eliminate Health Barriers and Disparities.)**                         |
+-----------------------------------------------------------------------+

**IMPORTANT:** To assist the reader in better understanding what is
meant by MCHB Strategic Research Issue #II, the following are examples
of possible areas of study addressing this issue. **[They are only
examples for illustrative purposes and do not constitute preferences for
funding consideration]{.underline}**. The Bureau strongly encourages
research studies that specifically address issues related to MCHB
investments and programs.

-   Determine the effectiveness, impact, and cost benefits of **cultural
    and linguistic competence** ^(5)^ in public health care and service
    systems.

-   Study the causes for disparities in access to and utilization of
    early and adequate prenatal care in different regions of the
    country, differentiating by rural, urban and frontier areas, and the
    effects of such disparities.

-   Investigate the effects of interdisciplinary and collaborative
    practice of health professions (including but not limited to
    nursing, oral health, pharmacy, mental health and pediatrics) on
    reducing barriers to health care access.

-   Assess the impact of community-based genetic counseling and
    education programs in medically underserved communities to evaluate
    whether increased genetic counseling and education programs will
    make a difference in access by underserved communities to genetic
    resources and services.

-   Study interventions to reduce racial/ethnic disparities in
    pre-term/low birth weight and other infant health outcomes.

-   Study the contribution of contextual effects on disparities in MCH
    outcomes.

+-----------------------------------------------------------------------+
| **Strategic Research Issue #III. Services and systems to assure       |
| quality of care ^(6)^ for MCH populations.**                          |
|                                                                       |
| **(Correlates to MCHB Strategic Plan: FYs 2003-2007,**                |
|                                                                       |
| **Goal 5: Assure Quality of Care.)**                                  |
+-----------------------------------------------------------------------+

**IMPORTANT:** To assist the reader in better understanding what is
meant by MCHB Strategic Research Issue #III, the following are examples
of possible areas of study

addressing this issue. **[They are only examples for illustrative
purposes and do not constitute preferences for funding
consideration]{.underline}**. The Bureau strongly encourages research
studies that specifically address issues related to MCHB investments and
programs.

-   Explore mechanisms of information transfer of evidence-based MCH
    strategies that lead to enhanced quality of provider practices and
    consumer behavior.

-   Determine the effectiveness and impact of the current system of care
    (both public and private) to assure that women and infants receive
    risk-appropriate perinatal care.

-   Study the extent to which children and adolescents needing
    **emergency medical services** actually receive them and the quality
    of care received from hospital emergency departments.

```{=html}
<!-- -->
```
-   Study the impact of specific characteristics of the medical home,
    such as the use of written "care plans," ^(7)^ on improvements in
    the quality of care for CSHCN.

-   Study how duration, organization and content of visits for clinical
    preventive services affect the quality of anticipatory
    guidance/health counseling provided to children, adolescents and
    women.

-   Investigate the factors that promote quality of health care service
    delivery, with attention to understanding the effectiveness and
    impact of interdisciplinary training of MCH professionals.

-   Investigate factors that decrease fragmentation of MCH service
    delivery.

+-----------------------------------------------------------------------+
| **Strategic Research Issue #IV. Promoting the healthy development of  |
| MCH populations.**                                                    |
|                                                                       |
| **(Correlates with MCHB Strategic Plan: FYs 2003-2007,**              |
|                                                                       |
| **Goal 2: Promote an Environment that Supports Maternal and Child     |
| Health.)**                                                            |
+-----------------------------------------------------------------------+

**IMPORTANT:** To assist the reader in better understanding what is
meant by MCHB Strategic Research Issue #IV, the following are examples
of possible areas of study addressing this issue. **[They are only
examples for illustrative purposes and do not constitute preferences for
funding consideration]{.underline}**. The Bureau strongly encourages
research studies that specifically address issues related to MCHB
investments and programs.

-   Study the effectiveness of health promotion and prevention
    strategies for infant, child, adolescent and adult populations
    (e.g., **Bright Futures Guidelines**) that use coordinated
    strategies and a variety of venues involving the clinical setting,
    the community and the home environment.

-   Conduct **longitudinal studies of health and normative development**
    in special populations of children such as minority children;
    children with special health needs; and children of low
    socioeconomic status (SES), rural, migrant and homeless backgrounds.

-   Study the effectiveness of health promotion and prevention
    strategies to promote healthy weight and prevent **obesity** in
    children and adolescence.

-   **Study child, parental (including fathers) and family strengths**,
    i.e., coping and resilience associated with pregnancy, childbearing
    and parenting; significant injuries; chronic and catastrophic
    disease conditions; and natural and man-made catastrophic events.

-   Study the effects of **family/professional partnerships and
    integrated community systems** on the health (including mental and
    oral health) and development of children.

-   Study the factors associated with health care utilization that
    positively influence health care utilization and **preventive health
    behaviors of women at various stages of and throughout their life
    span**.

-   Study the effectiveness of community outreach workers in increasing
    **breastfeeding** duration rates in underserved populations.

**DEFINITIONS**

^1^. **MCH Population** -- includes all of the Nation's women, infants,
children, adolescents, and their families, including fathers and
children with special health care needs **(MCHB Strategic Plan: FYs
2003-2007)**

^2^. **Children with Special Health Care Needs (CSHCN)** -- those who
have, or are at increased risk for, a chronic physical, developmental,
behavioral, or emotional condition and who also require health and
related services of a type or amount beyond that required by children
generally **(The American Academy of Pediatrics)**

^3^. **Care Coordination Services** -- those services that promote the
effective and efficient organization and utilization of resources to
assure access to necessary comprehensive services for children with
special health care needs and their families **(Title V sec. 501 (b)
(3)**)

^4^. **Medical Home** -- a medical home can be a physician's office, a
hospital outpatient clinic, a community health center or school-based
clinic, as long as it provides the services that constitute
comprehensive care -- continuous access to medical care; referral to
pediatric medical subspecialties and surgical specialists; and
interaction with child care, early childhood education programs and
schools to ensure that the special needs of the child and family are
addressed **(The American Academy of Pediatrics)**

^5^. **Cultural Competence --** a set of behaviors, attitudes, policies,
practices and structures that come together in a system, agency or among
professionals and enable that system and agency or those professionals
to work effectively in cross-cultural situations **(National Center for
Cultural Competence, 2002)**

**Linguistic Competence** -- the capacity of an organization and its
personnel to communicate effectively with persons of limited English
proficiency, those with low literacy skills or who are not literate, and
individuals with disabilities **(National Center for Cultural
Competence, 2002)**

^6^. **Quality of Care** -- 1) safe-avoiding injuries to patients from
the care that is intended to help them; 2) effective-providing services
based on scientific knowledge to all who could benefit and refraining
from providing services to those not likely to benefit; 3)
patient-centered---providing care that is respectful of and responsive
to individual preferences, needs and values and ensuring that patient
values guide all clinical decisions; 4) timely-reducing waits and
sometimes harmful delays for both those who receive and those who give
care; 5) efficient-avoiding waste, including waste of equipment,
supplies, ideas and energy; and 6) equitable-providing care that does
not vary in quality because of personal characteristics such as gender,
ethnicity, geographic location, and socioeconomic status **(National
Committee for Quality Assurance-NCQA)**

**^7^. Care Plan -** a comprehensive care plan combines a medical
summary, an emergency care plan, and an action care plan. It provides
information that can be shared across providers; a ready reference in an
emergency; and an action plan that prioritizes concerns, identifies
specific tasks to address concerns, assigns responsibility for tasks,
evaluates outcomes, and is done in collaboration with the child/youth
and family **(Division of Services for Children with Special Health
Needs, MCHB, HRSA)**

**Appendix F**

**MCHB Performance Measures and OMB Approved Data Forms**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

+--------------------------------+---------------+--------------------+
| **03 PERFORMANCE MEASURE**     | The percent   |                    |
|                                | of completed  |                    |
| **Goal 1: Provide National     | MCHB          |                    |
| Leadership for MCHB**          | supported     |                    |
|                                | projects      |                    |
| **(Strengthen the MCH          | publishing    |                    |
| knowledge base and support     | findings in   |                    |
| scholarship within the MCH     | peer-reviewed |                    |
| community)**                   | journals.     |                    |
|                                |               |                    |
| **Level: Grantee**             |               |                    |
|                                |               |                    |
| **Category: Information        |               |                    |
| Dissemination**                |               |                    |
+--------------------------------+---------------+--------------------+
| **GOAL**                       | To increase   |                    |
|                                | the number of |                    |
|                                | study         |                    |
|                                | findings from |                    |
|                                | research      |                    |
|                                | projects that |                    |
|                                | are published |                    |
|                                | in            |                    |
|                                | peer-reviewed |                    |
|                                | journals.     |                    |
+--------------------------------+---------------+--------------------+
|                                |               |                    |
+--------------------------------+---------------+--------------------+
| **MEASURE**                    | The percent   |                    |
|                                | of completed  |                    |
|                                | MCHB          |                    |
|                                | supported     |                    |
|                                | projects      |                    |
|                                | publishing    |                    |
|                                | findings in   |                    |
|                                | peer-reviewed |                    |
|                                | journals.     |                    |
+--------------------------------+---------------+--------------------+
|                                |               |                    |
+--------------------------------+---------------+--------------------+
| **DEFINITION**                 | *             |                    |
|                                | *Numerator:** |                    |
+--------------------------------+---------------+--------------------+
|                                | Number of     |                    |
|                                | completed     |                    |
|                                | projects      |                    |
|                                | publishing    |                    |
|                                | main study    |                    |
|                                | findings in   |                    |
|                                | peer-reviewed |                    |
|                                | journals no   |                    |
|                                | later than 3  |                    |
|                                | years         |                    |
|                                | following     |                    |
|                                | completion in |                    |
|                                | a cohort      |                    |
|                                | year.         |                    |
+--------------------------------+---------------+--------------------+
|                                | **D           |                    |
|                                | enominator:** |                    |
+--------------------------------+---------------+--------------------+
|                                | Total number  |                    |
|                                | of completed  |                    |
|                                | projects in a |                    |
|                                | cohort year.  |                    |
+--------------------------------+---------------+--------------------+
|                                | **Units:**    | **Text:** Percent  |
|                                | 100           |                    |
+--------------------------------+---------------+--------------------+
|                                | A completed   |                    |
|                                | project means |                    |
|                                | that the      |                    |
|                                | funding       |                    |
|                                | period has    |                    |
|                                | ended and the |                    |
|                                | final report  |                    |
|                                | has been      |                    |
|                                | submitted by  |                    |
|                                | the grantee.  |                    |
|                                |               |                    |
|                                | Cohort year   |                    |
|                                | is defined as |                    |
|                                | projects      |                    |
|                                | completed in  |                    |
|                                | a given       |                    |
|                                | fiscal year.  |                    |
|                                | Each cohort   |                    |
|                                | year will be  |                    |
|                                | collected for |                    |
|                                | three years.  |                    |
+--------------------------------+---------------+--------------------+
|                                |               |                    |
+--------------------------------+---------------+--------------------+
| **HEALTHY PEOPLE 2010          | Related to    |                    |
| OBJECTIVE**                    | Goal 1:       |                    |
|                                | Improve       |                    |
|                                | access to     |                    |
|                                | c             |                    |
|                                | omprehensive, |                    |
|                                | high-quality  |                    |
|                                | health care   |                    |
|                                | services      |                    |
|                                | (Objectives   |                    |
|                                | 1.1- 1.16).   |                    |
+--------------------------------+---------------+--------------------+
|                                |               |                    |
+--------------------------------+---------------+--------------------+
| **DATA SOURCE(S) AND ISSUES**  | -   Attached  |                    |
|                                |     data      |                    |
|                                |               |                    |
|                                |    collection |                    |
|                                |     form will |                    |
|                                |     be sent   |                    |
|                                |     annually  |                    |
|                                |     to        |                    |
|                                |     grantees  |                    |
|                                |     after the |                    |
|                                |     funding   |                    |
|                                |     period    |                    |
|                                |     for 3     |                    |
|                                |     years.    |                    |
|                                |               |                    |
|                                | -   Some      |                    |
|                                |               |                    |
|                                |   preliminary |                    |
|                                |               |                    |
|                                |   information |                    |
|                                |     may be    |                    |
|                                |     gathered  |                    |
|                                |     from      |                    |
|                                |     mandated  |                    |
|                                |     project   |                    |
|                                |     final     |                    |
|                                |     reports.  |                    |
+--------------------------------+---------------+--------------------+
|                                |               |                    |
+--------------------------------+---------------+--------------------+
| **SIGNIFICANCE**               | To be         |                    |
|                                | successful,   |                    |
|                                | MCH           |                    |
|                                | information   |                    |
|                                | must reach    |                    |
|                                | professionals |                    |
|                                | who are       |                    |
|                                | delivering    |                    |
|                                | services,     |                    |
|                                | developing    |                    |
|                                | programs and  |                    |
|                                | making policy |                    |
|                                | in order to   |                    |
|                                | ensure that   |                    |
|                                | the latest    |                    |
|                                | ev            |                    |
|                                | idence-based, |                    |
|                                | scientific    |                    |
|                                | knowledge is  |                    |
|                                | applied in    |                    |
|                                | practice and  |                    |
|                                | policy        |                    |
|                                | development.  |                    |
|                                | Peer reviewed |                    |
|                                | journals are  |                    |
|                                | considered    |                    |
|                                | one of the    |                    |
|                                | best methods  |                    |
|                                | for           |                    |
|                                | distributing  |                    |
|                                | new knowledge |                    |
|                                | because of    |                    |
|                                | their wide    |                    |
|                                | circulation   |                    |
|                                | and rigorous  |                    |
|                                | standard of   |                    |
|                                | review.       |                    |
+--------------------------------+---------------+--------------------+

**Appendix F (Cont'd)**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

DATA COLLECTION FORM FOR DETAIL SHEET #03

**LIST OF PUBLICATIONS RELATED TO THE RESEARCH PROJECT FUNDED OR**

**CO-FUNDED BY MCHB**

OMB #0915-0272

Expiration Date:  January 31, 2006

FUNDED PROJECT
#:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PROJECT TITLE:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRINCIPAL INVESTIGATOR:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

GRANTEE/INSTITUTION:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

(At the time the research was conducted)

######## 

######## **TYPE OF PROJECT: Research \_\_\_\_ Training \_\_\_\_\_\_ Programmatic \_\_\_\_\_\_\_**

**LIST OF PUBLICATIONS**

**Produced by or for the Funded Project**

Please attach a reprint of listed article(s) to this form

**Appendix F (Cont'd)**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

+-----------------------------------+-----------------------------------+
| # 10 PERFORMANCE MEASURE          | The degree to which MCHB          |
|                                   | supported programs have           |
| **Goal 2: Eliminate Health        | incorporated cultural competence  |
| Barriers & Disparities**          | elements into their policies,     |
|                                   | guidelines, contracts and         |
| **(Develop and promote health     | training.                         |
| services and systems of care      |                                   |
| designed to eliminate disparities |                                   |
| and barriers across MCH           |                                   |
| populations)**                    |                                   |
|                                   |                                   |
| **Level: Grantee**                |                                   |
|                                   |                                   |
| **Category: Cultural Competence** |                                   |
+-----------------------------------+-----------------------------------+
| **GOAL**                          | To increase the number of MCHB    |
|                                   | supported programs that have      |
|                                   | integrated cultural competence    |
|                                   | into their policies, guidelines,  |
|                                   | contracts and training.           |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **MEASURE**                       | The degree to which MCHB          |
|                                   | supported programs have           |
|                                   | incorporated cultural competence  |
|                                   | elements into their policies,     |
|                                   | guidelines, contracts and         |
|                                   | training.                         |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **DEFINITION**                    | Attached is a checklist of 23     |
|                                   | elements that demonstrate         |
|                                   | cultural competency. Please check |
|                                   | the degree to which the elements  |
|                                   | have been implemented. The answer |
|                                   | scale is 0-69. Please keep the    |
|                                   | completed checklist attached.     |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **HEALTHY PEOPLE 2010 OBJECTIVE** | Related to Objective 16.23:       |
|                                   | Increase the proportion of States |
|                                   | and jurisdictions that have       |
|                                   | service systems for children with |
|                                   | or at risk for chronic and        |
|                                   | disabling conditions as required  |
|                                   | by Public Law 101-239.            |
|                                   |                                   |
|                                   | Related to Objective 23.11        |
|                                   | (Developmental) Increase the      |
|                                   | proportion of State and local     |
|                                   | public health agencies that meet  |
|                                   | national performance standards    |
|                                   | for essential public health       |
|                                   | services.                         |
|                                   |                                   |
|                                   | Related to Objective 23.15        |
|                                   | (Developmental) Increase the      |
|                                   | proportion of Federal, Tribal,    |
|                                   | State, and local jurisdictions    |
|                                   | that review and evaluate the      |
|                                   | extent to which their statutes,   |
|                                   | ordinances, and bylaws assure the |
|                                   | delivery of essential public      |
|                                   | health services.                  |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **DATA SOURCE(S) AND ISSUES**     | -   Attached data collection form |
|                                   |     to be completed by grantees.  |
|                                   |                                   |
|                                   | -   There is no existing national |
|                                   |     data source to measure the    |
|                                   |     extent to which MCHB          |
|                                   |     supported programs have       |
|                                   |     incorporated cultural         |
|                                   |     competence elements into      |
|                                   |     their policies, guidelines,   |
|                                   |     contracts and training.       |
+-----------------------------------+-----------------------------------+
|                                   |                                   |
+-----------------------------------+-----------------------------------+
| **SIGNIFICANCE**                  | Over the last decade, researchers |
|                                   | and policymakers have emphasized  |
|                                   | the central influence of cultural |
|                                   | values and cultural/linguistic    |
|                                   | barriers: health seeking          |
|                                   | behavior, access to care, and     |
|                                   | racial and ethnic disparities. In |
|                                   | accordance with these concerns,   |
|                                   | cultural competence objectives    |
|                                   | have been: (1) incorporated into  |
|                                   | the MCHB strategic plan; and (2)  |
|                                   | in guidance materials related to  |
|                                   | the Omnibus Budget Reconciliation |
|                                   | Act of 1989 (OBRA '89), which is  |
|                                   | the legislative mandate that      |
|                                   | health programs supported by MCHB |
|                                   | Children with Special Health Care |
|                                   | Needs (CSHCN) provide and promote |
|                                   | family centered, community‑based, |
|                                   | coordinated care.                 |
+-----------------------------------+-----------------------------------+

**Appendix F (Cont'd)**

**DATA COLLECTION FORM FOR DETAIL SHEET #10**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

Using a scale of 0-3, please rate the degree to which your grant program
has incorporated the following cultural competence elements into your
policies, guidelines, contracts and training.

+------+------+------+------+------------------------------------------+
| *    | *    | *    | *    | **Element**                              |
| *0** | *1** | *2** | *3** |                                          |
+------+------+------+------+------------------------------------------+
|      |      |      |      | **CORE FUNCTIONS:** Our organization     |
|      |      |      |      | incorporates the following culturally    |
|      |      |      |      | competent core function elements:        |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 1.  Performs needs/assets assessments    |
|      |      |      |      |     with the culturally diverse groups   |
|      |      |      |      |     we serve.                            |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 2.  Collects and analyzes data according |
|      |      |      |      |     to different cultural groups (e.g.   |
|      |      |      |      |     race, ethnicity, language).          |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 3.  Designs services to meet the needs   |
|      |      |      |      |     of culturally diverse groups (e.g.   |
|      |      |      |      |     use of traditional healers, flexible |
|      |      |      |      |     times of services, language          |
|      |      |      |      |     services).                           |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 4.  Uses data on different groups for    |
|      |      |      |      |     program development.                 |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 5.  Considers barriers and the provision |
|      |      |      |      |     of appropriate strategies to address |
|      |      |      |      |     them.                                |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 6.  Evaluates and monitors quality       |
|      |      |      |      |     services (via customer satisfaction  |
|      |      |      |      |     surveys, focus groups, chart         |
|      |      |      |      |     reviews).                            |
+------+------+------+------+------------------------------------------+
|      |      |      |      | Is there a policy to incorporate         |
|      |      |      |      | cultural competence in the core          |
|      |      |      |      | functions? *None\_\_\_ Informal\_\_\_    |
|      |      |      |      | Formal\_\_\_ In process\_\_\_*           |
+------+------+------+------+------------------------------------------+
|      |      |      |      | **TRAINING/HUMAN RESOURCES**: Our        |
|      |      |      |      | organization incorporates the following  |
|      |      |      |      | culturally competent training/human      |
|      |      |      |      | resource elements:                       |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 1.  Employs a culturally diverse and     |
|      |      |      |      |     linguistically and culturally        |
|      |      |      |      |     competent staff.                     |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 2.  Ensures the provision of training,   |
|      |      |      |      |     both in orientation and ongoing      |
|      |      |      |      |     professional development, for staff, |
|      |      |      |      |     volunteers, contractors and          |
|      |      |      |      |     subcontractors in the area of        |
|      |      |      |      |     cultural and linguistic competence.  |
+------+------+------+------+------------------------------------------+
|      |      |      |      | Is there a policy to incorporate         |
|      |      |      |      | cultural competence in training and      |
|      |      |      |      | human resources?                         |
|      |      |      |      |                                          |
|      |      |      |      | *None\_\_\_ Informal\_\_\_ Formal\_\_\_  |
|      |      |      |      | In process\_\_\_*                        |
+------+------+------+------+------------------------------------------+
|      |      |      |      | **COLLABORATION:** Our organization      |
|      |      |      |      | collaborates with informal community     |
|      |      |      |      | leaders/groups (e.g. natural networks,   |
|      |      |      |      | informal leaders, spiritual leaders,     |
|      |      |      |      | ethnic media, family advocacy groups) in |
|      |      |      |      | various aspects of the following         |
|      |      |      |      | categories::                             |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 1.  Program planning                     |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 2.  Service delivery                     |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 3.  Evaluation/monitoring of services    |
+------+------+------+------+------------------------------------------+
|      |      |      |      | **COLLABORATION:** Our organization      |
|      |      |      |      | collaborates with families of culturally |
|      |      |      |      | diverse groups in various aspects of the |
|      |      |      |      | following categories:                    |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 4.  Program planning                     |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 5.  Service delivery                     |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 6.  Evaluation/monitoring of services    |
+------+------+------+------+------------------------------------------+
|      |      |      |      | Is there a policy to support the above   |
|      |      |      |      | mentioned collaborative activities?      |
|      |      |      |      | *None\_\_\_ Informal\_\_\_ Formal\_\_\_  |
|      |      |      |      | In process\_\_\_*                        |
+------+------+------+------+------------------------------------------+

+------+------+------+------+------------------------------------------+
|      |      |      |      | **RESOURCE ALLOCATION:** Our             |
|      |      |      |      | organization's allocation of resources   |
|      |      |      |      | adequately meets the unique access,      |
|      |      |      |      | information and service needs of         |
|      |      |      |      | culturally diverse groups in the         |
|      |      |      |      | following program areas:                 |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 1.  Planning                             |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 2.  Implementation                       |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 3.  Evaluation/Monitoring (e.g. customer |
|      |      |      |      |     satisfaction surveys, focus groups)  |
+------+------+------+------+------------------------------------------+
|      |      |      |      | Is there a policy to support the         |
|      |      |      |      | allocation of fiscal resources for the   |
|      |      |      |      | needs and services for culturally        |
|      |      |      |      | diverse groups?                          |
|      |      |      |      |                                          |
|      |      |      |      | *None\_\_\_ Informal\_\_\_ Formal\_\_\_  |
|      |      |      |      | In process\_\_\_*                        |
+------+------+------+------+------------------------------------------+
|      |      |      |      | **CONTRACTS:** Our agency puts language  |
|      |      |      |      | in contracts that addresses our goals to |
|      |      |      |      | incorporate cultural competence for      |
|      |      |      |      | culturally and linguistically diverse    |
|      |      |      |      | groups in the following areas**:**       |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 1.  Needs/assets assessments             |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 2.  Outreach                             |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 3.  Specialized services                 |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 4.  Training for                         |
|      |      |      |      |     contractors/subcontractors           |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 5.  Sufficient funds to support 1-e      |
+------+------+------+------+------------------------------------------+
|      |      |      |      | 6.  Reporting requirements for a-e       |
+------+------+------+------+------------------------------------------+
|      |      |      |      | Is there a policy to support monitoring  |
|      |      |      |      | of contractors/ subcontractors?          |
|      |      |      |      |                                          |
|      |      |      |      | *None\_\_\_ Informal\_\_\_ Formal\_\_\_  |
|      |      |      |      | In process\_\_\_*                        |
+------+------+------+------+------------------------------------------+

0=Not Met

1=Partially Met

2=Mostly Met

3=Completely Met

Total the numbers in the boxes (possible 0‑69 score)
\_\_\_\_\_\_\_\_\_\_

**Appendix F (Cont'd)**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**OMB Approved DATA FORM 1**

**MCHB PROJECT BUDGET DETAILS FOR FY \_\_\_\_\_\_\_**

OMB #0915-0272

Expiration Date:  January 31, 2006

**1. MCHB GRANT AWARD AMOUNT** \$\_\_\_\_\_\_\_\_\_**\_**

**2. UNOBLIGATED BALANCE** \$\_\_\_\_\_\_\_\_\_**\_**

**3. MATCHING FUNDS** (Required: Yes \[ \] No \[ \] If yes, amount)
\$\_\_\_\_\_\_\_\_\_\_

> A. Local funds \$\_\_\_\_\_\_\_

B.  State funds \$\_\_\_\_\_\_\_

C.  Program Income \$\_\_\_\_\_\_\_

D.  Applicant/Grantee Funds \$\_\_\_\_\_\_\_

> E. Other funds \$\_\_\_\_\_\_\_

**4. OTHER PROJECT FUNDS** (Not included in 3 above)
\$\_\_\_\_\_\_\_\_\_\_

> A. Local funds \$\_\_\_\_\_\_\_

B.  State funds \$\_\_\_\_\_\_\_

C.  Program Income (Clinical or Other) \$\_\_\_\_\_\_\_

D.  Applicant/Grantee Funds (includes in-kind) \$\_\_\_\_\_\_\_

> E. Other funds (including private sector, e.g., \$\_\_\_\_\_\_\_
>
> Foundations)

**5**. **TOTAL PROJECT FUNDS** (Total lines 1 through 4)
\$\_\_\_\_\_\_\_\_\_\_

**6. FEDERAL COLLABORATIVE FUNDS**

(Source(s) of additional Federal funds contributing to the project)

> Other MCHB Funds (Do not repeat grant funds from Line 1)
>
> 1\) SPRANS \$\_\_\_\_\_\_\_\_
>
> 2\) CISS \$\_\_\_\_\_\_\_\_
>
> 3\) SSDI \$\_\_\_\_\_\_\_\_
>
> 4\) Abstinence Education \$\_\_\_\_\_\_\_\_
>
> 5\) Healthy Start \$\_\_\_\_\_\_\_\_

6)  EMSC \$\_\_\_\_\_\_\_\_

7)  Bioterrorism \$\_\_\_\_\_\_\_\_

8)  Traumatic Brain Injury \$\_\_\_\_\_\_\_\_

9)  State Title V Block Grant \$\_\_\_\_\_\_\_\_

10) Other \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_

> Other HRSA Funds
>
> 1\) HIV/AIDS \$\_\_\_\_\_\_\_\_

2\) Primary Care \$\_\_\_\_\_\_\_\_

3\) Health Professions \$\_\_\_\_\_\_\_\_

4\) Other \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_

Other Federal Funds

1\) CMS \$\_\_\_\_\_\_\_\_

2\) SSI \$\_\_\_\_\_\_\_\_

3\) Agriculture (WIC/other) \$\_\_\_\_\_\_\_\_

4\) ACF \$\_\_\_\_\_\_\_\_

5\) CDC \$\_\_\_\_\_\_\_\_

6\) SAMHSA \$\_\_\_\_\_\_\_\_

7\) NIH \$\_\_\_\_\_\_\_\_

8\) Education \$\_\_\_\_\_\_\_\_

9\) Other: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$\_\_\_\_\_\_\_\_

> \$\_\_\_\_\_\_\_\_
>
> \$\_\_\_\_\_\_\_\_

**7. TOTAL COLLABORATIVE FEDERAL FUNDS**
\$[\_\_\_\_\_\_\_\_]{.underline}

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**INSTRUCTIONS FOR COMPLETION OF FORM 1**

**MCH BUDGET DETAILS FOR FY \_\_\_\_**

Line 1. Enter the amount of the Federal MCHB grant award for this
project.

Line 2. Enter the amount of carryover from the previous year's award, if
any (the unobligated balance).

Line 3. Indicate if matching funds are required by checking the
appropriate choice. If matching funds are required, enter the total
amount of the matching funds received or committed to the project. List
the amounts by source on lines 3A through 3D as appropriate. Do not
include "overmatch" funds. Any additional funds over and above the
amount required for matching purposes should be reported in Line 4.
Where appropriate, include the dollar value of in-kind contributions.

Line 4. Enter the amount of other funds received for the project, by
source on Lines 4A through 4E, specifying amounts from each source. Do
not include those amounts included in Line 3 above. Also include the
dollar value of in-kind contributions.

Line 5. Enter the sum of lines 1 through 4

Line 6. Line 6. Enter the amount of other Federal funds received on the
appropriate lines (A.1 through C.9) **other** than the MCHB grant award
for the project. Such funds would include those from other Departments,
other components of the Department of Health and Human Services, or
other MCHB grants or contracts.

Line 6C.1. Enter only project funds from the Center for Medicare and
Medicaid Services. Exclude Medicaid reimbursement, which is considered
Program Income and should be included on Line 3C or 4C.

If lines 6A.10, 6B.4, or 6C.9 are utilized, specify the source(s) of the
funds in the order of the amount provided, starting with the source of
the most funds. If more space is required, add a footnote at the bottom
of the page showing additional sources and amounts.

Line 7. Enter the sum of Lines 6A.1 through 6C.9.

NOTE: MCHB Training Grants must fill out Section "V. Detailed Budget" of
the currently approved HRSA-6025 in addition to this form.

**Appendix F (Cont'd)**

**OMB Approved DATA FORM 2**

**PROJECT FUNDING PROFILE**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

> [FY]{.underline} [FY]{.underline} [FY]{.underline} [FY]{.underline}
> [FY]{.underline}\_\_\_\_\_
>
> [Budgeted Expended]{.underline} [Budgeted Expended]{.underline}
> [Budgeted Expended]{.underline} [Budgeted Expended]{.underline}
> [Budgeted Expended]{.underline}

1.  [MCHB Grant]{.underline}

[Award]{.underline} [Amount]{.underline} \$ \$ \$ \$ \$ \$ \$ \$
\$\_\_\_\_\_\_\_ \$ \_\_\_\_\_\_\_\_

(*Line 1, Form 2)*

2\. [Unobligated]{.underline}

[Balance]{.underline} \$ \$ \$ \$ \$ \$ \$ \$ \$\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_

*(Line 2, Form 2)*

3\. [Matching]{.underline}

[Funds]{.underline}

[(If required)]{.underline} \$ \$ \$ \$ \$ \$ \$ \$ \$\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_

(*Line 3, Form 2)*

4\. [Other Project]{.underline}

[Funds]{.underline} \$ \$ \$ \$ \$ \$ \$ \$ \$\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_

(*Line 4, Form 2)*

5\. [Total Project]{.underline}

[Funds]{.underline} \$ \$ \$ \$ \$ \$ \$ \$ \$\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_

(*Line 5, Form 2)*

6\. [Total Federal]{.underline}

[Collaborative]{.underline}

[Funds]{.underline} \$ \$ \$ \$ \$ \$ \$ \$ \$\_\_\_\_\_\_\_ \$
\_\_\_\_\_\_\_\_

*(Line 7, Form 2)*

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**INSTRUCTIONS FOR THE COMPLETION OF FORM 2**

**PROJECT FUNDING PROFILE**

**Instructions:**

Complete all required data cells. If an actual number is not available,
use an estimate. Explain all estimates in a footnote.

The form is intended to provide at a glance funding data on the
estimated budgeted amounts and actual expended amounts of an MCH
project.

> For each fiscal year, the data in the columns labeled Budgeted on this
> form are to contain the same figures that appear on the Application
> Face Sheet and Lines 1 through 7 of Form 1. The lines under the
> columns labeled Expended are to contain the actual amounts expended
> for each grant year that has been completed.

**Appendix F (Cont'd)**

**OMB Approved DATA FORM 4**

**PROJECT BUDGET AND EXPENDITURES**

**By Types of Services**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

+---+----------------------+--------+---+--------+---+--------+---+--------+
|   |                      | **FY   |   |        |   | **FY   |   |        |
|   |                      | \_\_\_ |   |        |   | \_\_\_ |   |        |
|   |                      | \_\_** |   |        |   | \_\_** |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+
|   | **[TYPES OF          | **     |   | **     |   | **     |   | **     |
|   | SER                  | [Budge |   | [Expen |   | [Budge |   | [Expen |
|   | VICES]{.underline}** | ted]{. |   | ded]{. |   | ted]{. |   | ded]{. |
|   |                      | underl |   | underl |   | underl |   | underl |
|   |                      | ine}** |   | ine}** |   | ine}** |   | ine}** |
+---+----------------------+--------+---+--------+---+--------+---+--------+
| * | **[Direct Health     | \$     |   | \$     |   | \$     |   | \$     |
| * | Care                 |        |   |        |   |        |   |        |
| I | Ser                  |        |   |        |   |        |   |        |
| . | vices]{.underline}** |        |   |        |   |        |   |        |
| * |                      |        |   |        |   |        |   |        |
| * | (Basic Health        |        |   |        |   |        |   |        |
|   | Services and         |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Health Services for  |        |   |        |   |        |   |        |
|   | CSHCN.)              |        |   |        |   |        |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+
| * | **[Enabling          | \$     |   | \$     |   | \$     |   | \$     |
| * | Ser                  |        |   |        |   |        |   |        |
| I | vices]{.underline}** |        |   |        |   |        |   |        |
| I |                      |        |   |        |   |        |   |        |
| . | (Transportation,     |        |   |        |   |        |   |        |
| * | Translation,         |        |   |        |   |        |   |        |
| * |                      |        |   |        |   |        |   |        |
|   | Outreach, Respite    |        |   |        |   |        |   |        |
|   | Care, Health         |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Education, Family    |        |   |        |   |        |   |        |
|   | Support              |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Services, Purchase   |        |   |        |   |        |   |        |
|   | of Health            |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Insurance, Case      |        |   |        |   |        |   |        |
|   | Management,          |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | and Coordination     |        |   |        |   |        |   |        |
|   | with Medicaid,       |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | WIC and Education.)  |        |   |        |   |        |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+
| * | **[Population-Based  | \$     |   | \$     |   | \$     |   | \$     |
| * | Ser                  |        |   |        |   |        |   |        |
| I | vices]{.underline}** |        |   |        |   |        |   |        |
| I |                      |        |   |        |   |        |   |        |
| I | (Newborn Screening,  |        |   |        |   |        |   |        |
| . | Lead                 |        |   |        |   |        |   |        |
| * |                      |        |   |        |   |        |   |        |
| * | Screening,           |        |   |        |   |        |   |        |
|   | Immunization, Sudden |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Infant Death         |        |   |        |   |        |   |        |
|   | Syndrome             |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Counseling, Oral     |        |   |        |   |        |   |        |
|   | Health,              |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Injury Prevention,   |        |   |        |   |        |   |        |
|   | Nutrition, and       |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Outreach/Public      |        |   |        |   |        |   |        |
|   | Education.)          |        |   |        |   |        |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+
| * | **[Infrastructure    | \$     |   | \$     |   | \$     |   | \$     |
| * | Building             |        |   |        |   |        |   |        |
| I | Ser                  |        |   |        |   |        |   |        |
| V | vices]{.underline}** |        |   |        |   |        |   |        |
| . |                      |        |   |        |   |        |   |        |
| * | (Needs Assessment,   |        |   |        |   |        |   |        |
| * | Evaluation,          |        |   |        |   |        |   |        |
|   | Planning, Policy     |        |   |        |   |        |   |        |
|   | Development,         |        |   |        |   |        |   |        |
|   | Coordination,        |        |   |        |   |        |   |        |
|   | Quality Assurance,   |        |   |        |   |        |   |        |
|   | Standards            |        |   |        |   |        |   |        |
|   | Development,         |        |   |        |   |        |   |        |
|   |                      |        |   |        |   |        |   |        |
|   | Monitoring,          |        |   |        |   |        |   |        |
|   | Training, Applied    |        |   |        |   |        |   |        |
|   | Research, Systems of |        |   |        |   |        |   |        |
|   | Care, and            |        |   |        |   |        |   |        |
|   | Information          |        |   |        |   |        |   |        |
|   | Systems.)            |        |   |        |   |        |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+
| * | ######### **TOTAL**  | \$     |   | \$     |   | \$     |   | \$     |
| * |                      |        |   |        |   |        |   |        |
| V |                      |        |   |        |   |        |   |        |
| . |                      |        |   |        |   |        |   |        |
| * |                      |        |   |        |   |        |   |        |
| * |                      |        |   |        |   |        |   |        |
+---+----------------------+--------+---+--------+---+--------+---+--------+

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**INSTRUCTIONS FOR THE COMPLETION OF FORM 4**

**PROJECT BUDGET AND EXPENDITURES BY TYPES OF SERVICE**S

Complete all required data cells. If an actual number is not available,
make an estimate. Please explain all estimates in a footnote.
Administrative dollars should be allocated to the appropriate level(s)
of the pyramid on lines I, II, II or IV. If an estimate of
administrative funds use is necessary, one method would be to allocate
those dollars to Lines I, II, III and IV at the same percentage as
program dollars are allocated to Lines I through IV.

Note: Lines I, II and II are for projects providing services. If grant
funds are used to build the infrastructure for direct care delivery,
enabling or population-based services, these amounts should be reported
in Line IV (i.e., building data collection capacity for newborn hearing
screening).

Line I [Direct Health Care Services]{.underline} - enter the budgeted
and expended amounts for the appropriate fiscal year completed and
budget estimates only for all other years.

> **Direct Health Care Services** are those services generally delivered
> one-on-one between a health professional and a patient in an office,
> clinic or emergency room which may include primary care physicians,
> registered dietitians, public health or visiting nurses, nurses
> certified for obstetric and pediatric primary care, medical social
> workers, nutritionists, dentists, sub-specialty physicians who serve
> children with special health care needs, audiologists, occupational
> therapists, physical therapists, speech and language therapists,
> specialty registered dietitians. Basic services include what most
> consider ordinary medical care, inpatient and outpatient medical
> services, allied health services, drugs, laboratory testing, x-ray
> services, dental care, and pharmaceutical products and services. State
> Title V programs support - by directly operating programs or by
> funding local providers - services such as prenatal care, child health
> including immunizations and treatment or referrals, school health and
> family planning. For CSHCN, these services include specialty and
> sub-specialty care for those with HIV/AIDS, hemophilia, birth defects,
> chronic illness, and other conditions requiring sophisticated
> technology, access to highly trained specialists, or an array of
> services not generally available in most communities.

Line II [Enabling Services]{.underline} - enter the budgeted and
expended amounts for the appropriate fiscal year completed and budget
estimates only for all other years.

> **Enabling Services** allow or provide for access to and the
> derivation of benefits from, the array of basic health care services
> and include such things as transportation, translation services,
> outreach, respite care, health education, family support services,
> purchase of health insurance, case management, coordination of with
> Medicaid, WIC and educations. These services are especially required
> for the low income, disadvantaged, geographically or culturally
> isolated, and those with special and complicated health needs. For
> many of these individuals, the enabling services are essential - for
> without them access is not possible. Enabling services most commonly
> provided by agencies for CSHCN include transportation, care
> coordination, translation services, home visiting, and family
> outreach. Family support activities include parent support groups,
> family training workshops, advocacy, nutrition and social work.

Line III [Population-Based Services]{.underline} - enter the budgeted
and expended amounts for the appropriate fiscal year completed and
budget estimates only for all other years.

> **Population Based Services** are preventive interventions and
> personal health services, developed and available for the entire MCH
> population of the State rather than for individuals in a one-on-one
> situation. Disease prevention, health promotion, and statewide
> outreach are major components. Common among these services are newborn
> screening, lead screening, immunization, Sudden Infant Death Syndrome
> counseling, oral health, injury prevention, nutrition and
> outreach/public education. These services are generally available
> whether the mother or child receives care in the private or public
> system, in a rural clinic or an HMO, and whether insured or not.

Line IV [Infrastructure Building Services]{.underline} - enter the
budgeted and expended amounts for the appropriate fiscal year completed
and budget estimates only for all other years.

> **Infrastructure Building Services** are the base of the MCH pyramid
> of health services and form its foundation. They are activities
> directed at improving and maintaining the health status of all women
> and children by providing support for development and maintenance of
> comprehensive health services systems and resources including
> development and maintenance of health services standards/guidelines,
> training, data and planning systems. Examples include needs
> assessment, evaluation, planning, policy development, coordination,
> quality assurance, standards development, monitoring, training,
> applied research, information systems and systems of care. In the
> development of systems of care it should be assured that the systems
> are family centered, community based and culturally competent.

Line V [Total]{.underline} -- enter the total amounts for each column,
budgeted for each year and expended for each year completed.

**Appendix F (Cont'd)**

**OMB Approved DATA FORM 7**

DISCRETIONARY GRANT PROJECT

SUMMARY DATA

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

1.  **Project Service Focus**

> \[ \] Urban/Central City \[ \] Suburban \[ \] Metropolitan Area (city
> & suburbs)
>
> \[ \] Rural \[ \] Frontier \[ \] Border (US-Mexico)

2.  **Project Scope**

> \[ \] Local \[ \] Multi-county \[ \] State-wide
>
> \[ \] Regional \[ \] National

3.  **Grantee Organization Type**

> \[ \] State Program

\[ \] Community Government Program

\[ \] School District

\[ \] University/Institution of Higher Learning (Non-Hospital Based)

\[ \] Academic Medical Center

\[ \] Community-Based Non-Governmental Organization (Health Care)

\[ \] Community-Based Non-Governmental Organization (Non-Health Care)

\[ \] Professional Membership Organization (Individuals Constitute Its
Membership)

\[ \] National Organization (Other Organizations Constitute Its
Membership)

\[ \] National Organization (Non-Membership Based)

\[ \] Independent Research/Planning/Policy Organization

\[ \] Other
**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

4.  **Project Infrastructure Focus** (from MCH Pyramid) if applicable

\[ \] Guidelines/Standards Development and Maintenance

\[ \] Policies and Programs Study and Analysis

\[ \] Synthesis of Data and Information

\[ \] Translation of Data and Information for Different Audiences

\[ \] Dissemination of Information and Resources

\[ \] Quality Assurance

\[ \] Technical Assistance

\[ \] Training

\[ \] Systems Development

\[ \] Other

**5. Products and Dissemination**

+--------------------------------------------------------+-------------+
| # PRODUCTS                                             | #  NUMBER   |
+--------------------------------------------------------+-------------+
| Peer reviewed Journal Article                          |             |
+--------------------------------------------------------+-------------+
| Book/Chapter                                           |             |
+--------------------------------------------------------+-------------+
| Report/Monograph                                       |             |
+--------------------------------------------------------+-------------+
| Presentation                                           |             |
+--------------------------------------------------------+-------------+
| Doctoral Dissertation                                  |             |
+--------------------------------------------------------+-------------+
| Other:                                                 |             |
+--------------------------------------------------------+-------------+

**6. Demographic Characteristics of Project Participants for Clinical
Services Projects**

+-----------+--------+------+--------+--------+-------+-------+-----+---+
|           | **RACE |      |        |        |       | **E   |     |   |
|           | (In    |      |        |        |       | THNIC |     |   |
|           | dicate |      |        |        |       | ITY** |     |   |
|           | all    |      |        |        |       |       |     |   |
|           | that   |      |        |        |       |       |     |   |
|           | ap     |      |        |        |       |       |     |   |
|           | ply)** |      |        |        |       |       |     |   |
+===========+========+======+========+========+=======+=======+=====+===+
|           | Am     | A    | Black  | Native | White | His   | Not |   |
|           | erican | sian | or     | Ha     |       | panic | Hi  |   |
|           | Indian |      | A      | waiian |       | or    | spa |   |
|           | or     |      | frican | or     |       | L     | nic |   |
|           | Alaska |      | Am     | Other  |       | atino |     |   |
|           | Native |      | erican | P      |       |       | or  |   |
|           |        |      |        | acific |       |       | Lat |   |
|           |        |      |        | Is     |       |       | ino |   |
|           |        |      |        | lander |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| Pregnant  |        |      |        |        |       |       |     |   |
| Women     |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| Children  |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| Children  |        |      |        |        |       |       |     |   |
| with      |        |      |        |        |       |       |     |   |
| Special   |        |      |        |        |       |       |     |   |
| Health    |        |      |        |        |       |       |     |   |
| Care      |        |      |        |        |       |       |     |   |
| Needs     |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| Women     |        |      |        |        |       |       |     |   |
|           |        |      |        |        |       |       |     |   |
| (Not      |        |      |        |        |       |       |     |   |
| Pregnant) |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| Other     |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+
| ## TOTALS |        |      |        |        |       |       |     |   |
+-----------+--------+------+--------+--------+-------+-------+-----+---+

######### Clients' Primary Language(s)

######### \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

######### 

######### Resource/TA and Training Centers ONLY

######### **Answer all that apply.**

a.  Characteristics of Primary Intended Audience(s)

> \[ \] Policy Makers/Public Servants
>
> \[ \] Consumers

\[ \] Providers/Professionals

b\. Number of Requests Received/Answered: \_\_\_/\_\_\_\_

c.  Number of Continuing Education credits provided: \_\_\_\_\_\_\_

d.  Number of Individuals/Participants Reached: \_\_\_\_\_\_\_

e.  Number of Organizations Assisted: \_\_\_\_\_\_\_

f.  Major Type of TA or Training Provided:

> \[ \] continuing education courses,

\[ \] workshops,

\[ \] on-site assistance,

\[ \] distance learning classes

\[ \] other

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

> **INSTRUCTIONS FOR THE COMPLETION OF FORM 7**

###  PROJECT SUMMARY

**NOTE:** All information provided should fit into the space provided in
the form. Where information has previously been entered in forms 2
through 9, the information will automatically be transferred
electronically to the appropriate place on this form.

**Section 1 -- Project Service Focus**

Select all that apply

#### Section 2 -- Project Scope

#### Choose the one that best applies to your project.

#### Section 3 -- Grantee Organization Type

#### Choose the one that best applies to your organization.

### Section 4 -- Project Infrastructure Focus

If applicable, choose all that apply.

**Section 5 -- Products and Dissemination**

Indicate the number of each type of product resulting from the project.

#### Section 6 -- Demographic Characteristics of Project Participants (for Clinical Services Projects)

#### Please fill in each of the cells as appropriate. 

#### Section 7 -- Clients Primary Language(s) (for Clinical Services Projects)

#### Indicate which languages your clients speak as their primary language, other than English. List up to three.

#### Section 8 -- Resource/TA and Training Centers (Only)

Answer all that apply.

**Appendix F (Cont'd)**

**OMB Approved DATA FORM 8**

**(For Research Projects ONLY)**

**MATERNAL & CHILD HEALTH DISCRETIONARY GRANT**

**PROJECT ABSTRACT**

**FOR FY\_\_\_\_**

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**I. PROJECT IDENTIFIER INFORMATION**

1\. Project Title:

2\. Project Number:

3.  Project Director:

4.  Principle Investigator(s), Discipline

**II. BUDGET**

1\. MCHB Grant Award \$\_\_\_\_\_\_\_\_\_\_\_\_\_

(Line 1, Form 2)

2\. Unobligated Balance \$\_\_\_\_\_\_\_\_\_\_\_\_\_

(Line 2, Form 2)

3.  Matching Funds (if applicable) \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 3, Form 2)

4.  Other Project Funds \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 4, Form 2)

5.  Total Project Funds \$\_\_\_\_\_\_\_\_\_\_\_\_\_

> (Line 5, Form 2)

**III. CARE EMPHASIS**

\[ \] Interventional

> \[ \] Non-interventional

## IV. POPULATION FOCUS 

\[ \] Neonates \[ \] Pregnant Women

\[ \] Infants \[ \] Postpartum Women

\[ \] Toddlers \[ \] Parents/Mothers/Fathers

\[ \] Preschool Children \[ \] Adolescent Parents

\[ \] School-Aged Children \[ \] Grandparents

\[ \] Adolescents \[ \] Physicians

\[ \] Adolescents (Pregnancy Related) \[ \] Others

\[ \] Young Adults (\>20)

**V. STUDY DESIGN**

> \[ \] Experimental
>
> \[ \] Quasi-Experimental
>
> \[ \] Observational

#### VI. TIME DESIGN 

\[ \] Cross-sectional

\[ \] Longitudinal

\[ \] Mixed

**VII. RESEARCH ISSUES AND QUESTIONS OF FOCUS**

> From the Maternal and Child Health Bureau (MCHB) Strategic Research
> Issues: Fiscal Years (FYs)
>
> 2004 -- 2009.

**ABSTRACT (From PHS Form 398, Form Page 2)**

> Primary area addressed by research:
>
> Secondary area addressed by research:

## VIII. KEY WORDS

## IX. ANNOTATION

OMB \# 0915-0298

EXPIRATION DATE:  March 31, 2009

**INSTRUCTIONS FOR THE COMPLETION OF FORM 8**

**MATERNAL & CHILD HEALTH**

# RESEARCH PROJECT ABSTRACT

**NOTE:** All information provided should fit into the space provided in
the form. Do not exceed the space provided. This form is to be completed
in addition to Form PHS 398 (for new applications) or Form PHS 2590 (for
continuation applications).

> Where information has previously been entered in forms 1 through 5,
> the information will automatically be transferred electronically to
> the appropriate place on this form.

**Section I -- Project Identifier Information**

Provide the requested information for Lines 1 through 4:

Project Title: List the appropriate shortened title for the project.

Project Number: This is the number assigned to the project when funded.

Project Director: The name and degree(s) of the project director as
listed on the grant application.

Principle Investigator: The name and discipline

#### 

#### Section II -- Budget

####  The amounts for Lines 1 through 5 will be transferred from Form 1, Lines 1 through 5. 

#### 

#### Section III -- Care Emphasis

Indicate whether the study is interventional or non-interventional.

#### Section IV -- Population Focus

Indicate which population(s) is the focus of the study. Check all that
apply.

#### Section V -- Study Design

#### Indicate which type of design the study uses.

#### Section VI -- Time Design

Indicate which type of design the study uses.

**Section VII -- Strategic Research Issues of Focus (DO NOT EXCEED THE
SPACE PROVIDED)**

Provide a brief statement of the primary and secondary (if applicable)
areas to be addressed by the research. Indicate if the research area(s)
addresses research issue(s) in the *Maternal and Child Health Bureau
(MCHB) Strategic Research Issues: Fiscal Years (FYs) 2004 -- 2009.*

#### Section VIII -- Abstract (From Instructions for PHS 398).

**Section IX - -Key Words**

Key words describe the project, including populations served. A list of
key words used to classify active projects is included. Choose keywords
from this list when describing your project.

**Section X -- Annotation**

Provide a three- to five-sentence description of your project that
identifies the project's purpose, the needs and problems, which are
addressed, the goals and objectives of the project, the activities,
which will be used to attain the goals, and the materials, which will be
developed.

**Guidance Appendix G**

**Menu of Suggested Key Words for Project Abstracts**

A list of keywords used to describe MCHB-funded projects follows. Please
choose from this list when selecting terms to classify your project.

If no term on this list adequately describes a concept that you would
like to convey, please select a term which you think is appropriate and
include it in your list of keywords.

Access to Health Care

Adolescent Health Programs

Adolescent Nutrition

Adolescent Parents

Adolescent Pregnancy

Adolescent Pregnancy Prevention

Adolescent Risk Behavior Prevention

Adolescents

Adolescents with Disabilities

Advocacy

African Americans

Agricultural Safety

AIDS

AIDS Prevention

Alaska Natives

Alcohol

American Academy of Pediatrics

American College of Obstetricians and Gynecologists

American Public Health Association

Amniocentesis

Anemia

Anticipatory Guidance

Appalachians

Arthritis

Asian Language Materials

Asians

Asthma

Attachment

Attachment Behavior

Attention Deficit Disorder

Audiology

Audiometry

Audiovisual Materials

Baby Bottle Tooth Decay

Battered Women

Behavior Disorders

Behavioral Pediatrics

Bereavement

Bicycle Helmets

Bicycle Safety

Bilingual Services

Biochemical Genetics

Blindness

Blood Pressure Determination

Body Composition

Bonding

Brain Injuries

Breast Pumps

Breastfeeding

Bronchopulmonary Dysplasia

Burns

Cambodians

Caregivers

Case Management

Cerebral Palsy

Chelation Therapy

Child Abuse

Child Abuse Prevention

Child Care

Child Care Centers

Child Care Workers

Child Mortality

Child Neglect

Child Nutrition

Child Sexual Abuse

Childhood Cancer

Children with Special Health Needs

Child Death Review

Chronic Illnesses and Disabilities

Cleft Lip

Cleft Palate

Clinical Genetics

Clinics

Cocaine

Collaborative Office Rounds

Communicable Diseases

Communication Disorders

Communication Systems

Community Based Health Education

Community Based Health Services

Community Based Preventive Health

Community Development

Community Health Centers

Community Integrated Service System

Community Participation

Compliance

Comprehensive Primary Care

Computer Linkage

Computer Systems

Conferences

Congenital Abnormalities

Consortia

Continuing Education

Continuity of Care

Cost Effectiveness

Counseling

County Health Agencies

Craniofacial Abnormalities

Cultural Diversity

Cultural Sensitivity

Curricula

Cystic Fibrosis

Cytogenetics

Data Analysis

Data Collection

Data Systems

Databases

Deafness

Decision Making Skills

Delayed Development

Dental Sealants

Dental Treatment of Children with Disabilities

Depression

Developmental Disabilities

Developmental Evaluation

Developmental Screening

Diagnosis

Diarrhea

Dietitians

Dispute Resolution

Dissemination

Distance Education

Divorce

DNA Analysis

Down Syndrome

Drowning

Early Childhood Development

Early Intervention

Electronic Bulletin Boards

Electronic Mail

Eligibility Determination

Emergency Medical Services for Children

Emergency Medical Technicians

Emergency Room Personnel

Emotional Disorders

Emotional Health

Employers

Enabling Services

Enteral Nutrition

EPSDT

Erythrocyte Protoporphyrin

Ethics

Evoked Otoacoustic Emissions

Failure to Thrive

Families

Family Centered Health Care

Family Centered Health Education

Family Characteristics

Family Environment

Family Medicine

Family Planning

Family Professional Collaboration

Family Relations

Family Support Programs

Family Support Services

Family Violence Prevention

Farm Workers

Fathers

Feeding Disorders

Fetal and Infant Mortality Review

Fetal Alcohol Effects

Fetal Alcohol Syndrome

Financing

Food Preparation in Child Care

Formula

Foster Care

Foster Children

Foster Homes

Foster Parents

Fragile X Syndrome

Genetic Counseling

Genetic Disorders

Genetic Screening

Genetic Services

Genetics Education

Gestational Weight Gain

Glucose Intolerance

Governors

Grief

Gynecologists

Hawaiians

Head Start

Health Care Financing

Health Care Reform

Health care utilization

Health Education

Health Insurance

Health Maintenance Organizations

Health Professionals

Health Promotion

Health Supervision

Healthy Mothers Healthy Babies Coalition

Healthy Start Initiative

Healthy Tomorrows Partnership for Children

Hearing Disorders

Hearing Loss

Hearing Screening

Hearing Tests

Hemoglobinopathies

Hemophilia

Hepatitis B

Hispanics

HIV

Hmong

Home Health Services

Home Visiting for At Risk Families

Home Visiting Programs

Home Visiting Services

Homeless Persons

Hospitals

Hygiene

Hyperactivity

Hypertension

Illnesses in Child Care

Immigrants

Immunization

Incarcerated Women

Incarcerated Youth

Indian Health Service

Indigence

Individualized Family Service Plans

Infant Health Care

Infant Morbidity

Infant Mortality

Infant Mortality Review Programs

Infant Nutrition

Infant Screening

Infant Temperament

Infants

Information Networks

Information Services

Information Sources

Information Systems

Injuries

Injury Prevention

Intensive Care

Interagency Cooperation

Interdisciplinary Teams

Internship and Residency

Intubation

Iron Deficiency Anemia

Iron Supplements

Jews

Juvenile Rheumatoid Arthritis

Laboratories

Lactose Intolerance

Language Barriers

Language Disorders

Laotians

Lead Poisoning

Lead Poisoning Prevention

Lead Poisoning Screening

Leadership Training

Learning Disabilities

Legal Issues

Life Support Care

Literacy

Local Health Agencies

Local MCH Programs

Low Birthweight

Low Income Population

Lower Birthweight

Males

Managed Care

Managed Competition

Marijuana

Marital Conflict

Maternal and Child Health Bureau

Maternal Nutrition

MCH Research

Media Campaigns

Medicaid

Medicaid Managed Care

Medical Genetics

Medical History

Medical Home

Mental Health

Mental Health Services

Mental Retardation

Metabolic Disorders

Mexicans

Micronesians

Migrant Health Centers

Migrants

Minority Groups

Minority Health Professionals

Mobile Health Units

Molecular Genetics

Morbidity

Mortality

Motor Vehicle Crashes

Multiple Births

Myelodysplasia

National Information Resource Centers

National Programs

Native Americans

Needs Assessment

Neonatal Intensive Care

Neonatal Intensive Care Units

Neonatal Mortality

Neonates

Networking

Neurological Disorders

Newborn Screening

Nurse Midwives

Nurses

Nutrition

Obstetricians

Occupational Therapy

One Stop Shopping

Online Databases

Online Systems

Oral Health

Organic Acidemia

Otitis Media

Outreach

P. L. 99-457

Pacific Islanders

Pain

Paraprofessional Education

Parent Education

Parent Education Programs

Parent Networks

Parent Professional Communication

Parent Support Groups

Parent Support Services

Parental Visits

Parenteral Nutrition

Parenting Skills

Parents

Patient Education

Patient Education Materials

Pediatric Advanced Life Support Programs

Pediatric Dentistry

Pediatric Intensive Care Units

Pediatric Nurse Practitioners

Pediatricians

Peer Counseling

Peer Support Programs

Perinatal Health

Phenylketonuria

Physical Disabilities

Physical Therapy

Pneumococcal Infections

Poisons

Preconception Care

Pregnant Adolescents

Pregnant Women

Prematurity

Prenatal Care

Prenatal Diagnosis

Prenatal Screening

Preschool Children

Preterm Birth

Preventive Health Care

Preventive Health Care Education

Primary Care

Professional Education in Adolescent Health

Professional Education in Behavioral Pediatrics

Professional Education in Breastfeeding

Professional Education in Chronic Illnesses and Disabilities

Professional Education in Communication Disorders

Professional Education in CSHN

Professional Education in Cultural Sensitivity

Professional Education in Dentistry

Professional Education in Developmental Disabilities

Professional Education in EMSC

Professional Education in Family Medicine

Professional Education in Genetics

Professional Education in Lead Poisoning

Professional Education in MCH

Professional Education in Metabolic Disorders

Professional Education in Nurse Midwifery

Professional Education in Nursing

Professional Education in Nutrition

Professional Education in Occupational Therapy

Professional Education in Physical Therapy

Professional Education in Primary Care

Professional Education in Psychological Evaluation

Professional Education in Pulmonary Disease

Professional Education in Social Work

Professional Education in Violence Prevention

Provider Participation

Psychological Evaluation

Psychological Problems

Psychosocial Services

Public Health Academic Programs

Public Health Education

Public Health Nurses

Public Policy

Public Private Partnership

Puerto Ricans

Pulmonary Disease

Quality Assurance

Recombinant DNA Technology

Referrals

Regional Programs

Regionalized Care

Regulatory Disorders

Rehabilitation

Reimbursement

Repeat pregnancy prevention

Research

Residential Care

Respiratory Illnesses

Retinitis Pigmentosa

Rheumatic Diseases

RNA Analysis

Robert Wood Johnson Foundation

Runaways

Rural Population

Russian Jews

Safety in Child Care

Safety Seats

Sanitation in Child Care

School Age Children

School Dropouts

School Health Programs

School Health Services

School Nurses

Schools

Screening

Seat Belts

Self Esteem

Sensory Impairments

Service Coordination

Sex Roles

Sexual Behavior

Sexuality Education

Sexually Transmitted Diseases

Shaken Infant Syndrome

Siblings

Sickle Cell Disease

Sleep Disorders

Smoking during Pregnancy

Social Work

Southeast Asians

Spanish Language Materials

Special Education Programs

Specialized Care

Specialized Child Care Services

Speech Disorders

Speech Pathology

Spina Bifida

Spouse Abuse

Standards of Care

State Health Agencies

State Health Officials

State Legislation

State Programs

State Staff Development

State Systems Development Initiative

Stress

Substance Abuse

Substance Abuse Prevention

Substance Abuse Treatment

Substance Abusing Mothers

Substance Abusing Pregnant Women

Substance Exposed Children

Substance Exposed Infants

Sudden Infant Death Syndrome

Suicide

Supplemental Security Income Program

Support Groups

Surveys

Tay Sachs Disease

Technology Dependence

Teleconferences

Television

Teratogens

Terminally Ill Children

Tertiary Care Centers

Thalassemias

Third Party Payers

Title V Programs

Toddlers

Training

Transportation

Trauma

Tuberculosis

Twins

Uninsured

Unintentional Injuries

University Affiliated Programs

Urban Population

Urinary Tract Infections

Usher Syndrome

Vietnamese

Violence

Violence Prevention

Vision Screening

Vocational Training

Waiver 1115

Well Baby Care

Well Child Care

WIC

Youth in Transition