U.S. Department of Health and Human Services

**Health Resources and Services Administration**

**Maternal and Child Health Bureau**

**Emergency Medical Services for Children Program**

> **Emergency Medical Services for Children**
>
> **Targeted Issues Grants (EMSCT)**
>
> **New Competition**
>
> **HRSA-07-014**
>
> **Catalog of Federal Domestic Assistance (CFDA)**
>
> **No. 93.127**
>
> []{.mark}

**PROGRAM GUIDANCE**

Fiscal Year *2007*

**Application Due Date in Grants.gov: *April 16, 2007***

**Release Date: *February 16, 2007***

**Date of Issuance*: February16, 2007***

> *Tina Turgel, RN, BSN, RN-C*
>
> *Nurse Consultant, Emergency Medical Services for Children Program*
>
> *Telephone: 301-443-5599*

*Fax: 301-443-1296*

Authority: *Public Health Service Act, Title XIX, Section 1910*

[]{#__RefHeading___Toc151370888 .anchor}EXECUTIVE SUMMARY

**Emergency Medical Services for Children Targeted Issues Grants**

We are pleased to provide you with the Emergency Medical Services for
Children (EMSC) Guidance for Targeted Issues. Grant support is available
from the Division of Child, Adolescent and Family Health (DCAFH), 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). Please read the entire guidance carefully before
completing the application.

Targeted Issue Demonstration grants are intended to meet HRSA/MCHB
priorities of improving the health infrastructure and systems of care as
well as assuring quality of care. Applicants should address specific
needs in the field of pediatric emergency care that transcend state
boundaries. Typically, the projects result in a new product/resource or
the demonstration of the effectiveness of a model system component or
service of value to the nation. Objectives must meet a demonstrable
need, and methodologies and strategies for achieving the objectives must
be realistic, appropriate and scientifically sound. Each application
must contain an evaluation plan that contains measurable outcomes and
clearly defined time frames for conducting the evaluation.

**Qualified Applicants: State governments** and **accredited schools of
medicine** are the only eligible applicants for funding under the EMSC
Program.

**Number of Grants**: 7

**Funds per year:** up to \$200,000

**Application Availability:** February 16, 2007

**Deadline:** April 16, 2007

**Award Date:** September 1, 2007

**Project Period:** September 1, 2007 -- August 31, 2010

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

[]{.mark}

**Mail**: Ms. Mickey Reynolds

> Grants Management Specialist
>
> HRSA Division of Grants Management Operations
>
> Parklawn Building, Room 11A-16
>
> 5600 Fishers Lane
>
> Rockville, Maryland 20857

**Fax:** (301) 443-6686

**Electronic Mail:** <mreynolds@hrsa.gov>

[]{.mark}

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

**Mail**:

> Tina Turgel, RN, BSN, RN-C
>
> HRSA/MCHB EMSC Program
>
> Parklawn Building, Room 18A-38
>
> 5600 Fishers Lane
>
> Rockville, Maryland 20857

**Fax:** 301-443-1296 (attention: Tina Turgel)

**Electronic Mail**: [cturgel@hrsa.gov]{.underline}

[]{.mark}

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

**Mail:** EMSC National Resource Center

8737 Colesville Road

Silver Spring, MD 20910

**Phone:** (202) 884-4927

**Fax:** (202) 884-6845

**Electronic Mail:** <information@emscnrc.com>

[]{.mark}

Please submit your application early. Applications submitted on-line
after the application deadline will not be accepted. **The application**
**deadline is April 16, 2007 at 8:00 P.M. ET.**

**Table of Contents**

[EXECUTIVE SUMMARY 2](#__RefHeading___Toc151370888)

[I. Funding Opportunity Description 7](#__RefHeading___Toc151370889)

[1. Purpose 7](#__RefHeading___Toc151370890)

[2. Background 7](#__RefHeading___Toc151370891)

[II. Award Information 9](#__RefHeading___Toc151370892)

[1. Type of Award 9](#__RefHeading___Toc151370893)

[2. Summary of Funding 10](#__RefHeading___Toc151370894)

[III. Eligibility Information 10](#__RefHeading___Toc151370895)

[1. Eligible Applicants 10](#Eligibility_who)

[2. Cost Sharing/Matching 10](#__RefHeading___Toc151370897)

[3. Other 10](#__RefHeading___Toc151370898)

[IV. Application and Submission Information
10](#__RefHeading___Toc151370899)

[1. Address to Request Application Package
10](#__RefHeading___Toc151370900)

[**a.** **Application Materials** 10](#__RefHeading___Toc151370901)

[2. Content and Form of Application Submission
11](#__RefHeading___Toc151370902)

[**a.** **Application Format Requirements**
11](#Application_formatrequirements)

[**b.** **Application Format** 11](#__RefHeading___Toc151370904)

[SF 424 Non Construction -- Table of Contents
12](#sf-424-non-construction-table-of-contents)

[i. Application Face Page 14](#__RefHeading___Toc151370906)

[ii. Table of Contents 14](#__RefHeading___Toc151370907)

[iii. Application Checklist 14](#__RefHeading___Toc151370908)

[iv. Budget 14](#__RefHeading___Toc151370909)

[v. Budget Justification 14](#__RefHeading___Toc151370910)

[vi. Staffing Plan and Personnel Requirements
16](#__RefHeading___Toc151370911)

[vii. Assurances 17](#__RefHeading___Toc151370912)

[viii. Certifications 17](#__RefHeading___Toc151370913)

[ix. Project Abstract 17](#__RefHeading___Toc151370914)

[x. Program Narrative 17](#__RefHeading___Toc151370915)

[xi. Program Specific Forms 19](#__RefHeading___Toc151370916)

[xii. Attachments 20](#__RefHeading___Toc151370917)

[3. Submission Dates and Times 21](#__RefHeading___Toc151370918)

[**a.** **Application Due Date** 21](#__RefHeading___Toc151370919)

[**b.** **Late applications** 22](#__RefHeading___Toc151370920)

[4. Intergovernmental Review 22](#Application_materials)

[5. Funding Restrictions 22](#Application_fundingrestrictions)

[6. Other Submission Requirements 22](#__RefHeading___Toc151370923)

[V. Application Review Information 24](#__RefHeading___Toc151370924)

[1. Review Criteria 24](#__RefHeading___Toc151370925)

[2. Review and Selection Process 25](#__RefHeading___Toc151370926)

[3. Anticipated Announcement and Award Dates 25](#Review_ReviewCriteria)

[VI. Award Administration Information 25](#__RefHeading___Toc151370928)

[1. Award Notices 25](#__RefHeading___Toc151370929)

[2. Administrative and National Policy Requirements
26](#__RefHeading___Toc151370930)

[3. Reporting 27](#__RefHeading___Toc151370931)

[Performance Standards for Special Projects of Regional or National
Significance (SPRANS) and Other MCHB Discretionary Projects
27](#__RefHeading___Toc151370932)

[**a.** **Performance Measures and Program Data**
28](#__RefHeading___Toc151370933)

[**b.** **Post-Award Reporting** 28](#__RefHeading___Toc151370934)

[Performance Review 28](#__RefHeading___Toc151370935)

[VII. Agency Contacts 29](#__RefHeading___Toc151370936)

VII[I. Tips for Writing a Strong Application
30](#__RefHeading___Toc151370938)

[APPENDIX A: HRSA's Electronic Submission User Guide
32](#__RefHeading___Toc151370939)

[1. Introduction 34](#introduction)

[1.1 Document Purpose and Scope 34](#document-purpose-and-scope)

[1.2 Document Organization and Version Control
34](#document-organization-and-version-control)

[2. Noncompeting Continuation Application
34](#noncompeting-continuation-application)

[2.1 Process Overview 34](#process-overview)

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

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

[2.4 Apply through Grants.gov 36](#apply-through-grants.gov)

[2.4.1 Find Funding Opportunity 36](#find-funding-opportunity)

[2.4.2 Download Application Package 37](#download-application-package)

[2.4.3 Complete Application 37](#complete-application)

[2.4.4 Submit Application 37](#submit-application)

[2.4.5 Verify Status of Application 37](#verify-status-of-application)

[2.5 Verify in HRSA Electronic Handbooks
38](#verify-in-hrsa-electronic-handbooks)

[2.5.1 Verify Status of Application 38](#verify-status-of-application-1)

[2.5.2 Manage Access to Your Application
38](#manage-access-to-your-application)

[2.5.3 Check Validation Errors 38](#check-validation-errors)

[2.5.4 Fix Errors and Complete Application
39](#fix-errors-and-complete-application)

[2.5.5 Submit Application 39](#submit-application-1)

[2.6 Submit Signed Face Page 39](#submit-signed-face-page)

[3. Competing Application 39](#competing-application)

[3.1 Process Overview 39](#process-overview-1)

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

[3.3 Apply through Grants.gov 40](#apply-through-grants.gov-1)

[3.3.1 Find Funding Opportunity 40](#find-funding-opportunity-1)

[3.3.2 Download Application Package 41](#download-application-package-1)

[3.3.3 Complete Application 41](#complete-application-1)

[3.3.4 Submit Application 41](#submit-application-2)

[3.3.5 Verify Status of Application 41](#verify-status-of-application-2)

[3.4 Submit Signed Face Page 42](#submit-signed-face-page-1)

[4. General Instructions for Application Submission
42](#general-instructions-for-application-submission)

[4.1 Narrative Attachment Guidelines
42](#narrative-attachment-guidelines)

[4.1.1 Font 42](#font)

[4.1.2 Paper Size and Margins 43](#paper-size-and-margins)

[4.1.3 Names 43](#names)

[4.1.4 Section Headings 43](#section-headings)

[4.1.5 Page Numbering 43](#page-numbering)

[4.1.6 Allowable Attachment or Document Types
43](#allowable-attachment-or-document-types)

[4.2 Application Content Order (Table of Contents)
43](#application-content-order-table-of-contents)

[4.3 Page Limit 44](#page-limit)

[5. Customer Support Information 44](#customer-support-information)

[5.1.1 Grants.gov Customer Support 44](#grants.gov-customer-support)

[5.1.2 HRSA Call Center 44](#hrsa-call-center)

[5.1.3 HRSA Program Support 44](#hrsa-program-support)

[6. FAQs 45](#faqs)

[6.1 Software 45](#software)

[6.1.1 What are the software requirements for using Grants.gov?
45](#what-are-the-software-requirements-for-using-grants.gov)

[6.1.2 Why can't I download PureEdge Viewer onto my machine?
45](#why-cant-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?
45](#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?
46](#what-are-the-software-requirements-for-hrsa-ehbs)

[6.1.5 What are the system requirements for using HRSA EHBs on a
Macintosh computer?
46](#what-are-the-system-requirements-for-using-hrsa-ehbs-on-a-macintosh-computer)

[6.2 Application Receipt 46](#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?
46](#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?
46](#when-do-i-need-to-submit-my-application)

[6.2.3 What emails can I expect once I submit my application? Is email
reliable?
46](#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\"?
47](#if-a-resubmission-is-required-because-of-grants.gov-system-problems-will-these-be-considered-late)

[6.3 Application Submission 48](#application-submission)

[6.3.1 How can I make sure that my electronic application is presented
in the right order for objective review?
48](#how-can-i-make-sure-that-my-electronic-application-is-presented-in-the-right-order-for-objective-review)

[6.4 Grants.gov 48](#grants.gov)

[Appendix B -- Registering and Applying Through Grants.gov
49](#__RefHeading___Toc151370999)

[Appendix C EMSC Keywords 54](#__RefHeading___Toc151371000)

[Appendix D Biographical Sketch 55](#__RefHeading___Toc151371001)

[Appendix E Performance Measures 56](#__RefHeading___Toc151371002)

[Appendix F Financial, Demographic, and Abstract Forms
58](#__RefHeading___Toc151371003)

I.  []{#__RefHeading___Toc151370889 .anchor}**Funding Opportunity
    Description**

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1.   []{#__RefHeading___Toc151370890 .anchor}**Purpose**

> The mission of HRSA/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 and use 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).
>
> Targeted Issue Demonstration grants are intended to meet HRSA/MCHB
> priorities of improving the health infrastructure and systems of care
> as well as assuring quality of care. Applicants should address
> specific needs in the field of pediatric emergency care that transcend
> state boundaries. Typically, the projects result in a new
> product/resource or the demonstration of the effectiveness of a model
> system component or service of value to the nation. Objectives must
> meet a demonstrable need, and methodologies and strategies for
> achieving the objectives must be realistic, appropriate and
> scientifically sound. Each application must contain an evaluation plan
> that contains measurable outcomes and clearly defined time frames for
> conducting the evaluation.
>
> Evaluation is an important component of Targeted Issue grants, as
> rigorous evaluation identifies demonstration projects that are
> successful and unsuccessful. Evaluation permits prioritization of
> successful demonstration projects for development and implementation
> in other places in the nation. Evaluation in targeted issue projects
> should be rigorous and of sufficient quality to warrant publication of
> results..

2.   []{#__RefHeading___Toc151370891 .anchor}**Background**

> The Emergency Medical Services for Children (EMSC) grant program is
> administered by the Department of Health and Human Services (DHHS),
> Health Resources and Services Administration (HRSA), Maternal and
> Child Health Bureau (MCHB). The program is authorized by the Public
> Health Service Act, Title XIX, Section 1910.
>
> This Federal initiative evolved out of a growing recognition that
> children have unique needs in emergency situations \-- needs that
> often vary from those of adults due to physiological, developmental
> and psychological differences.
>
> Legislation passed by Congress in 1984 authorized the use of Federal
> funds to expand and improve emergency medical services for children in
> each State. Since 1984, 50 States, 5 territories and the District of
> Columbia, have received grants.
>
> The goal of the EMSC program is to reduce child and youth morbidity
> and mortality resulting from severe illness or injury. The EMSC
> program does not intend to promote the development of a separate EMS
> system for children, but rather to enhance the pediatric capability of
> EMS systems originally designed primarily for adults. "EMS" here is
> understood broadly to include the following components: prevention,
> prehospital EMS care, hospital based care, rehabilitation and reentry
> of the child into the community.

**Definitions**

> The following definitions are provided as guidance for applicants:

-   \"**[Children]{.underline}**\" means youths from birth through age
    18.

-   "[**Cultural Competence**"]{.underline} means a set of values,
    behaviors, attitudes, and practices within a system, organization,
    program, or among individuals that enables them to work effectively
    cross culturally. Further, it refers to the ability to honor and
    respect the beliefs, language, interpersonal styles and behaviors of
    individuals and families receiving services, as well as staff who
    are providing such services. Cultural competence is a dynamic,
    ongoing, developmental process that requires a long-term commitment
    and is achieved over time.

-   \"**[Emergency Medical Services]{.underline}**\" or \"**EMS**\"
    means services used in responding to an adult or child\'s need for
    immediate medical care in order to prevent loss of life and to
    prevent aggravation of physiological or psychological illness or
    injury and disability by appropriate intervention at the very early
    stages of the event. However, the EMSC program expands the view of
    emergency services to include primary prevention through
    rehabilitation activities.

-   \"**[Emergency Medical Services System]{.underline}**\" means an
    arrangement of personnel, facilities, and equipment for the
    effective and coordinated delivery of health care services in an
    appropriate geographical area, under emergency conditions (occurring
    either as a result of the patient\'s condition or of natural
    disasters or similar situations), and which has the authority and
    the resources to provide effective administration of the system. An
    \"appropriate geographical area\" means an area which is of
    sufficient size, population, and economic diversity so that an
    efficient and economically feasible EMS project can be established,
    taking into consideration existing medical service areas and health
    service areas. The EMS system is a continuum encompassing primary
    prevention, prehospital and emergency department care, critical care
    and acute hospitalization, rehabilitation, and return to the
    community. All of these activities must be coordinated with the
    child\'s primary care provider or \"medical home.\"

-   \"**[Family-Centered]{.underline}**\" includes the following key
    elements of care: maximum possible involvement of families in all
    phases of the EMSC continuum of care; clear and continuous
    communication between family members and the emergency care team;
    attention to the psychological needs of all family members; cultural
    competence of providers; consumer (parental) involvement in planning
    and needs assessment; organizational support for the formation of
    parent advocacy groups; and ongoing partnerships with such groups.

-   \"**[State]{.underline}**\" means one of the 50 States, the District
    of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa,
    and the Commonwealth of Northern Mariana Islands.

**[Program Requirements of the Grantee]{.underline}**

The focus area for Targeted Issues grant proposals should be related to
projects that will contribute to the development of a fully integrated
emergency care system that appropriately meets the needs of pediatric
patients.

[]{.mark}

Program Requirements are:

**A) Project Focus Area**

The focus area for targeted issue grants must have a pediatric focus and
be consistent with one or more of the priorities elucidated in the
following:

Emergency Care for Children: Growing Pains. 2006 *Institute of Medicine*

Available at: <http://www.iom.edu/CMS/3809/16107/35002.aspx>

Emergency Medical Services for Children. 1993 *Institute of Medicine*

Available at: <http://www.nap.edu/books/0309048885/html>

National EMS Research Agenda

Available at:
<http://www.nhtsa.gov/people/injury/ems/ems-agenda/toc.htm>

"Priorities for research in emergency medical services for children:
Results of a consensus conference," Seidel, et. al *Ann Emerg Med*
February 1999; 33:206-210

"Emergency Medical Services Outcomes Project I (EMSOP I): Prioritizing
conditions for outcomes research," Maio et. al, *Ann Emerg Med* April
1999; 33: 423-432

**B) Performance Measures**

Successful applicants to the Partnership grant **are required** to
report on Performance Measure #3. See Appendix E for performance measure
detail sheet and reporting instructions.

**C) Annual Grantee Meeting**

Include funding in the budget for a minimum of two persons to attend the
annual EMSC grantee meetings (the project investigator and another
individual with a designated role in the project). Attendance at this
meeting is a requirement of the EMSC grant program. There is no
registration fee for the meeting; however, participants need to budget
for travel to the Washington, D.C. area for 3 nights/4 days. The meeting
is anticipated to be 2 ½ days. Approximate hotel costs for Washington,
D.C. area are \$169 per night.

II. []{#__RefHeading___Toc151370892 .anchor}**Award Information**

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1.  []{#__RefHeading___Toc151370893 .anchor}**Type of Award**

> Funding will be provided in the form of a grant.

[]{.mark}

2.  []{#__RefHeading___Toc151370894 .anchor}**Summary of Funding**

[]{.mark}

> Program will provide funding for Federal fiscal years 2007-2009.
> Approximately \$1,400,000 is expected to be available annually to fund
> seven (7) grantees. Funding beyond the first year is dependent on the
> availability of appropriated funds in subsequent years, satisfactory
> grantee performance, and a determination that continued funding is in
> the best interest of the Government.

III. []{#__RefHeading___Toc151370895 .anchor}**Eligibility Information**

     []{#Eligibility_who .anchor}

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1.  **Eligible Applicants**

> **State Governments** and **Accredited Schools of Medicine** are the
> [only]{.underline} eligible applicants for funding under the EMSC
> program.

2.  []{#__RefHeading___Toc151370897 .anchor}**Cost Sharing/Matching**

> **No** cost sharing or matching is required.

3.  []{#__RefHeading___Toc151370898 .anchor}**Other**

> Applications that exceed the funding limit of \$200,000 per year for
> three years 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.

[]{.mark}

[]{.mark}

IV. []{#__RefHeading___Toc151370899 .anchor}**Application and Submission
    Information**

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1.  []{#__RefHeading___Toc151370900 .anchor}**Address to Request
    Application Package**

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a.  []{#__RefHeading___Toc151370901 .anchor}**Application Materials**

> **[The application and submission process has changed
> significantly]{.underline}**. 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 Public Health
> Service (PHS) Application Form 5161-1. 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.

910 Clopper Road, Suite 155 South

Gaithersburg, Md. 20878

Telephone: 877-477-2123

<HRSAGAC@hrsa.gov>

> []{.mark}
>
> Instructions for preparing portions of the application that must
> accompany Application Form 5161-1 appear in the "Application Format"
> section below.

2.  []{#__RefHeading___Toc151370902 .anchor}**Content and Form of
    Application Submission**

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a.  []{#Application_formatrequirements .anchor}**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, and letters of commitment and support.** Standard 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.**

b.  []{#__RefHeading___Toc151370904 .anchor}**Application Format**

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

### SF 424 Non Construction -- 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       **Form       **Instruction**          **HRSA/Program
  Section**           Type**                                Guidelines**
  ------------------- ------------ ------------------------ --------------------
  Application for     Form         Pages 1, 2 & 3 of the    Not counted in the
  Federal Assistance               SF-424 face page.        page limit
  (SF-424)                                                  

  Project             Attachment   Can be uploaded on page  Required attachment.
  Summary/Abstract                 2 of SF-424 - Box 15     Counted in the page
                                                            limit. Refer
                                                            guidance for
                                                            detailed
                                                            instructions.
                                                            Provide table of
                                                            contents specific to
                                                            this document only
                                                            as the first page

  Additional          Attachment   Can be uploaded on page  As applicable to
  Congressional                    2 of SF 424 - Box 16     HRSA; not counted in
  District                                                  the page limit

  HHS Checklist Form  Form         Pages 1 & 2 of the HHS   Not counted in the
  PHS-5161                         checklist.               page limit

  Project Narrative   Form         Supports the upload of   Not counted in the
  Attachment Form                  Project Narrative        page limit
                                   document                 

  Project Narrative   Attachment   Can be uploaded in       Required attachment.
                                   Project Narrative        Counted in the page
                                   Attachment form.         limit. Refer
                                                            guidance for
                                                            detailed
                                                            instructions.
                                                            Provide table of
                                                            contents specific to
                                                            this document only
                                                            as the first page

  SF-424A Budget      Form         Page 1 & 2 to supports   Not counted in the
  Information -                    structured budget for    page limit
  Non-Construction                 the request of Non       
  Programs                         construction related     
                                   funds                    

  SF-424B             Form         Supports assurances for  Not counted in the
  Assurances -                     non construction         page limit
  Non-Construction                 programs                 
  Programs                                                  

  Disclosure of       Form         Supports structured data Not counted in the
  Lobbying Activities              for lobbying activities. page limit
  (SF-LLL)                                                  

  Other Attachments   Form         Supports up to 15        Not counted in the
  Form                             numbered attachments.    page limit
                                   This form only contains  
                                   the attachment list      

  Attachment 1-15     Attachment   Can be uploaded in Other Refer to the
                                   Attachments form 1-15    attachment table
                                                            provided below for
                                                            **specific**
                                                            sequence. Counted in
                                                            the page limit
  ------------------------------------------------------------------------------

-   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.

-   Evidence of Non Profit status and invention related documents, if
    applicable, must be provided in the other attachment form.

-   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        Tables, Charts

  Attachment 2        Job Descriptions of Key Personnel

  Attachment 3        Biographical Sketches of Key Personnel

  Attachment 4        Letters of Agreement and/or Description(s) of
                      Proposed/Existing Contracts

  Attachment 5        Project Organizational Chart

  Attachment 6        Other Relevant Documents
  -----------------------------------------------------------------------

i.  []{#__RefHeading___Toc151370906 .anchor}***Application Face Page***

> Public Health Service (PHS) Application Form 5161-1, provided with the
> application package. Prepare this page according to instructions
> provided in the form itself. For information pertaining to the Catalog
> of Federal Domestic Assistance, the Catalog of Federal Domestic
> Assistance Number is 93.127.
>
> **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](http://www.hrsa.gov/grants/ccr.htm)
> or call 1-866-705-5711. Please include the DUNS number in item 8c on
> the application face page. Applications ***will not*** be reviewed
> without a DUNS number.
>
> Additionally, the applicant organization will be 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](http://www.hrsa.gov/grants/ccr.htm).
>
> .

ii. []{#__RefHeading___Toc151370907 .anchor}***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. []{#__RefHeading___Toc151370908 .anchor}***Application Checklist***

> Application Form 5161-1 provided with the application package

iv. []{#__RefHeading___Toc151370909 .anchor}***Budget***

> Application Form 5161-1 provided with the application package.
>
> Please complete sections A, B, E and F and then provide a line item
> budget for each grant year using the budget categories in the SF 424A.

v.  []{#__RefHeading___Toc151370910 .anchor}***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) at the time of application. Line item
> information must be provided to explain the costs entered in
> Application Form 5161-1. **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**
>
> This announcement is inviting applications for a project period of up
> to 3 years. Awards, on a competitive basis, will be for a one‑year
> budget period, although project periods may be for 3 years.
> Applications for continuation grants funded under these awards beyond
> the one-year budget period but within the 3 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.
>
> **Allowable Costs**
>
> The MCHB may support reasonable and necessary costs of EMSC grant
> projects within the scope of approved activities. Allowable costs may
> include salaries, equipment and supplies, travel, contracts,
> consultants, and other direct costs, as well as indirect costs. **Any
> indirect costs must be calculated at the other sponsored program rate,
> not at the research rate**. The MCHB adheres to administrative
> standards reflected in the Code of Federal Regulations, 45 CFR Part 92
> and 45 CFR Part 74. Subgrants are not allowed.
>
> 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, and the annual salary.
>
> *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 costs. 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 which
> negotiate them.
>
> *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.
>
> *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.
>
> *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 such as NEDARC workshops and NEMSIS meetings. Include
> funding in the budget for a **minimum of two persons** to attend the
> annual EMSC grantee meetings (the principal investigator and another
> individual with a designated role in the project). Attendance at this
> meeting is a **requirement** of the EMSC grant program.
>
> Listed below is information cost estimates that applicants may find
> helpful in preparing the cost estimates for their application. There
> is no registration fee. The 2007 Grantee Meeting is scheduled for June
> 17-19, 2006. Dates for the 2008 and 2009 Grantee are yet to be
> determined.
>
> 2007-2009: Grantee Meeting
>
> Lodging: 3 nights; Per Diem: 4 days
>
> Travel to Washington, D.C. area
>
> *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 that meet the definition of equipment.
>
> *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.
>
> *Other:* Put all costs that do not fit into any other category into
> this category and provide and 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. []{#__RefHeading___Toc151370911 .anchor}***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 as **Attachment 2** of this application. Copies of
> biographical sketches for any key employed personnel that will be
> assigned to work on the proposed project must be included as
> **Attachment 3** of this application.

vii. []{#__RefHeading___Toc151370912 .anchor}***Assurances***

> The fourth section of Application Form 5161-1 contains SF 424B and SF
> 424D, and concerns **Assurances**. EMSC applicants need to complete
> only **SF 424B** provided with the application package.

viii. []{#__RefHeading___Toc151370913 .anchor}***Certifications***

> The fifth section of Form 5161-1 deals with **Certifications** and
> sets forth certain requirements for grantees which have been
> legislatively implemented since the SF-424 assurances pages were last
> revised. This section must be completed by all applicants and is
> provided with the application package.

ix. []{#__RefHeading___Toc151370914 .anchor}***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.
>
> Use the format sheet provided in **Form 6** of this guidance (**see
> Appendix F**). In addition, please note the list of suggested keywords
> for use in preparing the abstract. Key words are terms under which the
> project will be listed in the subject index of the MCHB Abstract of
> Active Projects. Identify the most significant terms that best
> describe the project, including the population served. **Appendix C**
> provides a sample of common keywords for EMSC-supported programs.

x.  []{#__RefHeading___Toc151370915 .anchor}***Program Narrative***

> 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.
>
> The program narrative should be structured in the six (6) sections
> described below.
>
> Appendices are used to provide supporting documentation such as
> tables, charts, position descriptions, biographical sketches, and
> letters describing participation and support. **Substantive
> information corresponding to the review criteria must be contained
> within the program narrative**.

Use the following section headers for the Project Narrative:

*[Section 1.]{.underline} Introduction*

This section should briefly describe the purpose of the proposed
project. Provide a brief literature review that discusses the
significance of the project. State the overall goals of the project,
clearly relating the goals to the described problem(s), need, or
question to be answered.

*[Section II.]{.underline} Needs Assessment*

The target population and its health care needs must be described and
documented in this section. Demographic data should be used and cited
whenever possible to support the information provided. Please discuss
any relevant barriers in the service area that the project hopes to
overcome. This section should help reviewers understand how the project
will improve the emergency care of children and the project's potential
for replication nationally.

*[Section III.]{.underline} Methodology*

This section should provide detailed descriptions of the methodology for
accomplishing each project objective addressing the previously described
program requirements in this grant announcement as well as any other
proposed activities under this grant.

Provide a review of any preliminary studies or EMSC projects that may
illustrate the feasibility of the project.

Identify the plan for consultation and review by the applicant's
Institutional Review Board (IRB) if project is of a nature that would
require IRB approval.

Describe the methods, strategies, resources, and instruments to be used
to achieve each objective. Identify the populations to be served and
sample sizes for statistical correlations (if applicable). Describe
plans for development and dissemination of products. Provide the
rationale and justification for the methods, strategies, resources, and
instruments used.

Identify plans for utilization of advisory committees, special task
forces or teams in the accomplishment of project objectives. Describe
the composition of these groups and how their participation will benefit
the proposed project

Identify the key agencies and/or organizations that will contribute to
or participate in the project. Describe the role of each collaborating
agency, demonstrating consistency with the proposed project objectives.
Provide a letter of support or collaboration from each participating
agency in Appendix 4.

*[Section IV.]{.underline} Work Plan*

Describe the activities or steps that will be used to achieve each of
the objectives proposed in the methodology section. Use a time line that
includes each activity and identifies responsible staff.

*[Section V.]{.underline} Resolution of Challenges*

Discuss challenges that are likely to be encountered in designing and
implementing the activities described in the Work Plan and approaches
that will be used to resolve such challenges.

*[Section VI.]{.underline} Evaluation and Technical Support Capacity*

Provide a thorough description of the evaluation plan for measuring
achievement of each project objective.

Discuss current experience, skills, and knowledge, including individuals
on staff, materials published, and previous work of a similar nature.

*[Section VII.]{.underline} Organizational Information*

Describe the applicant's organizational structure and plan for
management of the proposed project. List the personnel who have
responsibilities for project activities and describe their roles and
responsibilities.

Identify plans for contracting work with individuals and/or
organizations. Include a letter of agreement from individuals or
organizations with which contracts are planned. Describe the process for
contracting with individuals or organizations if no such agreement
exists. Describe the process for monitoring contract performance.

xi. []{#__RefHeading___Toc151370916 .anchor}***Program Specific Forms***

> *1)  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.  An electronic system for
> reporting these data elements has been developed and is now available.

*2)  Performance Measure and Program Data for Emergency Medical Services
for Children Targeted Issues Grants*

To prepare applicants for these reporting requirements, the designated
performance measure and other program data collection are presented in
Appendices E-F.

> *3) Public Health System Reporting Requirements*
>
> This program is subject to the Public Health System Reporting
> Requirements (approved under OMB No. 0937-0195). Under these
> requirements, the community-based nongovernmental applicant must
> prepare and submit a Public Health System Impact Statement (PHSIS).
> The PHSIS is intended to provide information to State and local health
> officials to keep them apprised of proposed health services grant
> applications submitted by community-based nongovernmental
> organizations within their jurisdictions.
>
> Community-based non-governmental applicants (school of medicine
> applicants) are required to submit the following information to the
> head of the appropriate State and local health agencies in the area(s)
> affected no later than the Federal application receipt due date:

a\. a copy of the face page of the application (SF 424).

b\. a summary of the project (PHSIS), not to exceed one page, which
provides:

1\. a description of the population to be served,

2\. a summary of the services to be provided, and

> 3\. a description of the coordination planned with the appropriate
> State and local health agencies.
>
> The project abstract may be used in lieu of the one-page PHSIS if the
> applicant is required to submit a PHSIS.

xii. []{#__RefHeading___Toc151370917 .anchor}***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 project narrative. Be
> sure each attachment is clearly labeled.
>
> 1\) Attachment 1: *Tables, Charts, etc*.
>
> To give further details about the proposal.
>
> 2\) Attachment 2: *Job Descriptions for Key Personnel*
>
> Keep each to one page in length as much as is possible. Item 6 in the
> Program Narrative section of the PHS 5161-1 Form provides some
> guidance on items to include in a job description.
>
> 3\) Attachment 3: *Biographical Sketches of Key Personnel*
>
> Include biographical sketches for persons occupying the key positions
> described in the above *"Job Descriptions for Key Personnel."* The
> biographical sketch should not exceed 2 pages in length and a sample
> is provided as Appendix D of this grant guidance. In the event that a
> biographical sketch is included for an identified individual who is
> not yet hired, please include a letter of commitment from that person
> with the biographical sketch.
>
> 4\) Attachment 4: *Letters of Agreement and/or Description(s) of
> Proposed/Existing Contracts* (project specific) 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.
>
> 5\) Attachment 5: *Project Organizational Chart*
>
> Provide a one-page figure that depicts the organizational structure of
> the applicant agency and project, including subcontractors and other
> significant collaborators.
>
> 6\) Attachment 6: *Other Relevant Documents*
>
> Include here any other documents that are relevant to the application,
> including letters of support. Letters of support must be dated. In
> order for applicants to have maximum space for their narrative,
> multiple letters of support may be listed on one page that states who
> the letter of support is from and the date it was written
>
> **Include only letters of support which specifically indicate a
> commitment to the project/program (in-kind services, dollars, staff,
> space, equipment, etc.) Letters of agreements and support must be
> dated. List all other support letters on one page.**

3.  []{#__RefHeading___Toc151370918 .anchor}**Submission Dates and
    Times**

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a.   []{#__RefHeading___Toc151370919 .anchor}**Application Due Date**

> The due date for applications under this grant announcement is *April
> 16, 2007, 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.**

b.  []{#__RefHeading___Toc151370920 .anchor}**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.  []{#Application_materials .anchor}**Intergovernmental Review**

> **Executive Order 12372**
>
> []{#Application_fundingrestrictions .anchor}This program is subject to
> the provisions of Executive Order 12372, as implemented by 45 CFR 100.
> Executive Order 12372 allows States the option of setting up a system
> for reviewing applications from within their States for assistance
> under certain Federal programs. Application packages made available
> under this guidance will contain a listing of States which have chosen
> to set up such a review system, and will provide a State Single Point
> of Contact (SPOC) for the review. Information on states affected by
> this program and State Points of Contact may also be obtained from the
> Grants Management Officer listed in the AGENCY Contact(s) section, as
> well as from the following Web site:
> <http://www.whitehouse.gov/omb/grants/spoc.html>.
>
> All applicants other than federally recognized Native American Tribal
> Groups should contact their SPOC as early as possible to alert them to
> the prospective applications and receive any necessary instructions on
> the State process used under this Executive Order.
>
> Letters from the State Single Point of Contact (SPOC) in response to
> Executive Order 12372 are due sixty days after the application due
> date.

5.  **Funding Restrictions**

> Applicants responding to this announcement may request funding for a
> project period of up to 3 years, at no more than \$200,000 per year
> including indirect costs. 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.

6.  []{#__RefHeading___Toc151370923 .anchor}**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 an online application, 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: EMSCT*

Program Announcement No. HRSA-07-014

CFDA No. 93.127

910 Clopper Road, Suite 155 South

Gaithersburg, MD. 20878

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.  []{#__RefHeading___Toc151370924 .anchor}**Application Review
    Information**

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1.  []{#__RefHeading___Toc151370925 .anchor}**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
> Emergency Medical Services for Children Program has 6 review criteria:
>
> *Criterion 1:* NEED (10 points) - The extent to which the application
> describes the problem and associated contributing factors to the
> problem and clearly states the overall goals of the project.
>
> *Criterion 2:* RESPONSE (20 points) - The extent to which the proposed
> project responds to the "Purpose" and "Program Requirements of the
> Grantee" included in the program description. The clarity of the
> proposed objectives and their relationship to the identified project.
> The extent to which the activities (scientific or other) described in
> the application are capable of addressing the program requirements and
> attaining the project objectives.
>
> *Criterion 3:* EVALUATIVE MEASURES (20 points) - The effectiveness of
> the method proposed to monitor and evaluate the project results.
> Evaluative measures must be able to assess 1) to what extent the
> program objectives have been met and 2) to what extent these can be
> attributed to the project.
>
> *Criterion 4:* IMPACT (30 points) - The extent and effectiveness of
> plans for dissemination of project results and/or the extent to which
> project results may be national in scope and/or degree to which the
> project activities are replicable, and/or sustainability of the
> project beyond Federal Funding. The significance of the project in
> terms of its potential impact for improving the emergency care of
> children nationally.
>
> *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 projects. The capabilities of the
> applicant organization, and quality and availability of facilities and
> personnel to fulfill the needs and requirements of the proposed
> project.
>
> *Criterion 6:* SUPPORT REQUESTED (10 points) - The reasonableness of
> the proposed budget in relation to the objectives, the complexity of
> the activities, and the anticipated results.
>
> Requirement: A letter from the Institutional Review Board (IRB)
> stating contact has been made by the applicant and information has
> been received regarding the proposed project for those projects that
> may require IRB approval.

2.  []{#__RefHeading___Toc151370926 .anchor}**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.
>
> []{#Review_ReviewCriteria .anchor}

3.  **Anticipated Announcement and Award Dates**

> Anticipated award date is September 1, 2007.

VI. []{#__RefHeading___Toc151370928 .anchor}**Award Administration
    Information**

```{=html}
<!-- -->
```
1.  []{#__RefHeading___Toc151370929 .anchor}**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 the 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 start date of September 1, 2007.

2.  []{#__RefHeading___Toc151370930 .anchor}**Administrative and
    National Policy Requirements**

> Successful applicants must comply with the administrative requirements
> outlined in 45 CFR Part 74 or 45 CFR Part 92, as appropriate.
>
> Beginning October 1, 2006, HRSA grant awards will be subject to the
> requirements of the HHS Grants Policy Statement (HHS GPS) that are
> applicable to the grant based on recipient type and the purpose of
> award. This includes, as applicable, any requirements in Parts I and
> II of the HHS GPS that apply to the award, as well as any requirements
> of Part IV. The HHS GPS is available at <http://www.hrsa.gov/grants/>.
> The general terms and conditions in the HHS GPS will apply as
> indicated unless there are statutory, regulatory, or award-specific
> requirements to the contrary (as specified in the Notice of
> Award**).**
>
> **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 Environment**
>
> 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. In addition, Public Law 103-227, the Pro-Children
> Act of 1994, prohibits smoking in certain facilities (or in some
> cases, any portion of a facility) in which regular or routine
> education, library, childcare, health care or early childhood
> development services are provided to children.

3.  []{#__RefHeading___Toc151370931 .anchor}**Reporting**

> The successful applicant under this guidance must comply with the
> following reporting and review activities:
>
> a\. **Audit Requirements**
>
> 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
> http://www.whitehouse.gov/omb/circulars;
>
> b\. **Payment Management Requirements**
>
> Submit a quarterly electronic PSC-272 via the Payment Management
> System. The report identifies cash expenditures against the authorized
> funds for the grant. Failure to submit the report may result in the
> inability to access grant funds. The PSC-272 Certification page should
> be faxed to the PMS contact at the fax number listed on the 272 form,
> or it may be submitted to the:
>
> Division of Payment Management
>
> HHS/ASAM/PSC/FMS/DPM
>
> PO Box 6021
>
> Rockville, MD 20852
>
> Telephone: (877) 614-5533;

c.  **Status Reports**

> 1\. 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. More
> specific information will be included in your award notice;
>
> 2\. **Semi-Annual Performance Report.** Within 30 days following the
> end of six months from the award date, a semi-annual performance
> report shall be submitted. A standardized semi-annual report form will
> be sent to all successful applicants. Semi-Annual Reports should be
> e-mailed to **Mickey Reynolds** and **Tina Turgel** and
> **semiannualreports@emscnrc.com**. Their contact information can be
> found **in Section VII under Agency Contacts**.
>
> 3\. **Final Report**. Within 90 days following the end of the project
> period a final report will be due which shall contain information and
> data of interest to the EMSC program, the Department of Health and
> Human Services, the U.S. Congress, and other States. A standardized
> final report form will be sent to all successful applicants. Final
> Reports should be e-mailed to **Mickey Reynolds** and **Tina Turgel**
> and **finalreports@emscnrc.com**. Their contact information can be
> found **in Section VII under Agency Contacts**.

[]{#__RefHeading___Toc151370932 .anchor}**d. 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. **\
> **

[]{#__RefHeading___Toc151370933 .anchor}**(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 Appendices E-F.

[]{#__RefHeading___Toc151370934 .anchor}**(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.

[]{#__RefHeading___Toc151370935 .anchor}**e. Performance Review**

> HRSA's Office of Performance Review (OPR) serves as the agency's focal
> point for reviewing and enhancing the performance of HRSA funded
> programs within communities and States. As part of this agency-wide
> effort, HRSA grantees will be required, where appropriate, during
> their project period to participate in an on-site performance review
> of their HRSA funded program(s) by an OPR review team. When a grantee
> receives more than one HRSA grant, each of the grantee's HRSA funded
> programs will be reviewed during the same performance review.
>
> The purpose of performance review is to improve the performance of
> HRSA funded programs. Through systematic pre-site and on-site
> analysis, OPR works collaboratively with grantees and HRSA
> Bureaus/Offices to measure program performance, analyze the factors
> impacting performance, and identify effective strategies and
> partnerships to improve program performance, with a particular focus
> on outcomes. Upon completion of the performance review, grantees will
> be required to prepare an Action Plan to address any identified
> program requirement issues as well as identify key actions to improve
> program performance. In addition, performance reviews also provide an
> opportunity for grantees to offer direct feedback to the agency about
> the impact of HRSA policies on program implementation and performance
> within communities and States.
>
> For additional information on performance reviews, please visit:
> <http://www.hrsa.gov/performancereview>.

VII. []{#__RefHeading___Toc151370936 .anchor}**Agency Contacts**

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

####### Grants Management Specialist

> HRSA Division of Grants Management Operations
>
> Parklawn Building, Room 11A-16

####### 5600 Fishers Lane

> Rockville, Maryland 20857
>
> Telephone number: (301) 443-0724
>
> Fax number: (301) 443-6686
>
> E-mail address: <mreynolds@hrsa.gov>
>
> Additional information related to the overall program issues may be
> obtained by contacting:

####### Tina Turgel, RN, BSN, RN-C

> EMSC Program Nurse Consultant
>
> Maternal and Child Health Bureau
>
> Parklawn Building, Room 18A-38
>
> 5600 Fishers Lane
>
> Rockville, Maryland 20857
>
> Telephone Number: (301) 443-5599
>
> Fax Number (301) 443-1296 (Attn:Tina Turgel)
>
> E-mail address: <cturgel@hrsa.gov>
>
> Technical assistance regarding this funding announcement may be
> obtained by contacting:
>
> EMSC-NRC
>
> 8737 Colesville Road
>
> Silver Spring, MD 20910
>
> Telephone number: (202) 884-4927
>
> Fax number: (202) 884-6845
>
> Email address: information@emscnrc.com

VIII. []{#__RefHeading___Toc151370938 .anchor}**Tips for Writing a
      Strong Application**

> **Include DUNS Number.** You must include a DUNS Number to have your
> application reviewed. Applications ***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 item 8c 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 a 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 attachments.** Do not use the attachments
> 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
> 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.
>
> **Print out and carefully review an electronic application to ensure
> accuracy and completion.** When submitting electronically, print out
> the application before submitting it to ensure appropriate formatting
> and adherence to page limit requirements. **Check to ensure that all
> attachments are included before sending the application forward.**
>
> **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 received.**

[]{#__RefHeading___Toc151370939 .anchor}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}](http://GRANTS.GOV/) (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}](http://GRANTS.GOV/)
\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....

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}](http://GRANTS.GOV/) NOT ALREADY
REGISTERED)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...

3.3. APPLY THROUGH
[[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...

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 GRANT.GOV
HELP\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....

## 1. Introduction

### 1.1 Document Purpose and Scope

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

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

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

1.  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.

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

8.  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.

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

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

11. 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

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,
excluding Federal holidays.

-   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.

### 2.3 Project Director and Authorizing Official Need to Register with HRSA EHBs (if not already registered)

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

#### 2.4.1 Find Funding Opportunity

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 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 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,
excluding Federal holidays.

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

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,
excluding Federal holidays.

-   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

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

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

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

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.

#### 2.5.3 Check Validation Errors

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

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

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

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\>*

910 Clopper Road, Suite 155

Gaithersburg, MD. 20878

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

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

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)

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-   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,
excluding Federal holidays.

-   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

#### 3.3.1 Find Funding Opportunity

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 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 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,
excluding Federal holidays.

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

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,
excluding Federal holidays.

-   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

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

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 Entity Identifier field (box 5a 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\>*

910 Clopper Road, Suite 155 South

Gaithersburg, MD. 20878

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

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

#### 4.1.1 Font 

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. 

#### 4.1.2 Paper Size and Margins

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

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

Please put all section headings flush left in bold type.

#### 4.1.5 Page Numbering

**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

**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

### 4.2 Application Content Order (Table of Contents)

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

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

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, excluding
Federal holidays.

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

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

#### 5.1.2 HRSA Call Center

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

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

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

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?

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?

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?

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? 

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

#### 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?

**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?

**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.

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

**Competing Submissions:**

When you submit your competing 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\"?

**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

#### 6.3.1 How can I make sure that my electronic application is presented in the right order for objective review?

Follow the instructions provided in section 4.2 to ensure that your
application is presented in the right order and is compliant with all
the requirements.

### 6.4 Grants.gov

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>

[]{#__RefHeading___Toc151370999 .anchor}**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:

HRSA Grants Application Center

The Legin Group, Inc.

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

Program Announcement No. \[provide HRSA announcement number\]

CFDA No. \[provide the CFDA number\]

910 Clopper Road, Suite 155 South

Gaithersburg, MD 20878

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.

[]{#__RefHeading___Toc151371000 .anchor}Appendix C EMSC Keywords

A list of keywords used to describe EMSC 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 which you would like
to convey, please select a term which you think is appropriate and
include it in your list of keywords.

> Project Evaluation Public Education
>
> Strategic Planning First Responder Education
>
> Primary Care Provider Education Skill Retention
>
> Nurse Education EMS Equipment
>
> Physician Education
>
> Prehospital Education
>
> Quality Assurance and Improvement
>
> Needs Assessment
>
> Research
>
> EMS Transport Issues
>
> Family Centered Care
>
> Intentional Injury
>
> Unintentional Injury
>
> Disasters
>
> Mental Health
>
> School Health
>
> Child Care
>
> Child Death Review
>
> Child Abuse
>
> Medical Direction
>
> Color Coding
>
> EMS System Development
>
> Facility Designation or Recognition
>
> Regionalization
>
> Trauma Systems
>
> Telehealth or Telemedicine
>
> Critical Incident Stress Management (CISM)
>
> Post-traumatic Stress
>
> Substance Abuse
>
> Victims of Violence
>
> Adolescents
>
> Foster Children
>
> Homeless Children
>
> Suicide
>
> Data

[]{#__RefHeading___Toc151371001 .anchor}Appendix D Biographical Sketch

**Biographical Sketch**

Give the following information for all professional personnel
contributing to the project,

beginning with the Program Director. Photocopy this page for each
person.

*(DO NOT EXCEED 2 PAGES ON ANY INDIVIDUAL)*

NAME *(Last, first, middle initial)* TITLE BIRTH DATE *(Mo, Day, Yr)*

EDUCATION *(Begin with baccalaureate or other initial professional
education and include postdoctoral training)*

INSTITUTION AND LOCATION DEGREE YEAR CONFERRED FIELD OF STUDY

HONORS

MAJOR RESEARCH - PROFESSIONAL INTEREST

CURRENT RESEARCH AND OTHER GRANT SUPPORT

RESEARCH AND PROFESSIONAL EXPERIENCE: List in reverse chronological
order previous employment and experience. List in reverse chronological
order all publications, or most recent presentation if the 2 page limit
on the sketch presents a problem.

[]{#__RefHeading___Toc151371002 .anchor}Appendix E Performance Measures

+-----------------------------------+-----------------+-----------------+
| **03 PERFORMANCE MEASURE**        | The percent of  |                 |
|                                   | completed MCHB  |                 |
| **Goal 1: Provide National        | supported       |                 |
| Leadership for MCHB**             | projects        |                 |
|                                   | publishing      |                 |
| **(Strengthen the MCH knowledge   | findings in     |                 |
| base and support scholarship      | peer-reviewed   |                 |
| within the MCH 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.    |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | *               |                 |
|                                   | *Denominator:** |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | Total number of |                 |
|                                   | completed       |                 |
|                                   | projects in a   |                 |
|                                   | cohort year.    |                 |
+-----------------------------------+-----------------+-----------------+
|                                   | **Units:** 100  | **Text:**       |
|                                   |                 | Percent         |
+-----------------------------------+-----------------+-----------------+
|                                   | 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 OBJECTIVE** | Related to Goal |                 |
|                                   | 1: Improve      |                 |
|                                   | access to       |                 |
|                                   | comprehensive,  |                 |
|                                   | 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          |                 |
|                                   | evidence-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.         |                 |
+-----------------------------------+-----------------+-----------------+

> **DATA COLLECTION FORM FOR DETAIL SHEET #03**

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

**CO-FUNDED BY MCHB**

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

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

PRINCIPAL INVESTIGATOR:
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[]{#__RefHeading___Toc151371003 .anchor}Appendix F Financial,
Demographic, and Abstract Forms

**FORM 1**

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

+---+---+-------+--------------------+---------------------+-----+----+
| * | * |       |                    |                     |     | \$ |
| * | * |       |                    |                     |     |    |
| 1 | M |       |                    |                     |     |    |
| . | C |       |                    |                     |     |    |
| * | H |       |                    |                     |     |    |
| * | B |       |                    |                     |     |    |
|   | G |       |                    |                     |     |    |
|   | R |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | T |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | W |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | R |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | M |       |                    |                     |     |    |
|   | O |       |                    |                     |     |    |
|   | U |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | T |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
| * | * |       |                    |                     |     | \$ |
| * | * |       |                    |                     |     |    |
| 2 | U |       |                    |                     |     |    |
| . | N |       |                    |                     |     |    |
| * | O |       |                    |                     |     |    |
| * | B |       |                    |                     |     |    |
|   | L |       |                    |                     |     |    |
|   | I |       |                    |                     |     |    |
|   | G |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | T |       |                    |                     |     |    |
|   | E |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
|   | B |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | L |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | C |       |                    |                     |     |    |
|   | E |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
| * | * |       |                    |                     |     | \$ |
| * | * |       |                    |                     |     |    |
| 3 | M |       |                    |                     |     |    |
| . | A |       |                    |                     |     |    |
| * | T |       |                    |                     |     |    |
| * | C |       |                    |                     |     |    |
|   | H |       |                    |                     |     |    |
|   | I |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | G |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | U |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
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|   | R |       |                    |                     |     |    |
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|   | \ |       |                    |                     |     |    |
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|   | ] |       |                    |                     |     |    |
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|   | ] |       |                    |                     |     |    |
|   | I |       |                    |                     |     |    |
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|   | y |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
|   | , |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
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|   |   |       |                    |                     |     |    |
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|   | A |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | L |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | l |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | B |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | C |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | P |       |                    |                     |     |    |
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|   | g |       |                    |                     |     |    |
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|   | a |       |                    |                     |     |    |
|   | m |       |                    |                     |     |    |
|   | I |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | m |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | D |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | p |       |                    |                     |     |    |
|   | p |       |                    |                     |     |    |
|   | l |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | / |       |                    |                     |     |    |
|   | G |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | E |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | O |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | h |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
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|   | : |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
| * | * |       |                    |                     |     | \$ |
| * | * |       |                    |                     |     |    |
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|   | R |       |                    |                     |     |    |
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|   | C |       |                    |                     |     |    |
|   | T |       |                    |                     |     |    |
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|   | N |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
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|   | ) |       |                    |                     |     |    |
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|   | A |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
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|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
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|   | B |       |                    |                     | \$  |    |
|   | . |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
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|   | d |       |                    |                     |     |    |
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+---+---+-------+--------------------+---------------------+-----+----+
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|   | I |       |                    |                     |     |    |
|   | V |       |                    |                     |     |    |
|   | E |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | U |       |                    |                     |     |    |
|   | N |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
|   | * |       |                    |                     |     |    |
|   |   |       |                    |                     |     |    |
|   | ( |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | ( |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
|   | ) |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | l |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | l |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | b |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | g |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | h |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | p |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | j |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | c |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | ) |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | O |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | h |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | M |       |                    |                     |     |    |
|   | C |       |                    |                     |     |    |
|   | H |       |                    |                     |     |    |
|   | B |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
|   | ( |       |                    |                     |     |    |
|   | D |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | p |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | g |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
|   | f |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | o |       |                    |                     |     |    |
|   | m |       |                    |                     |     |    |
|   | L |       |                    |                     |     |    |
|   | i |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | 1 |       |                    |                     |     |    |
|   | ) |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 1\)   |                    |                     | \$  |    |
|   |   | S     |                    |                     |     |    |
|   |   | PRANS |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 2\)   |                    |                     | \$  |    |
|   |   | CISS  |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 3\)   |                    |                     | \$  |    |
|   |   | SSDI  |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 4\)   |                    |                     | \$  |    |
|   |   | Absti |                    |                     |     |    |
|   |   | nence |                    |                     |     |    |
|   |   | Educ  |                    |                     |     |    |
|   |   | ation |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 5\)   |                    |                     | \$  |    |
|   |   | He    |                    |                     |     |    |
|   |   | althy |                    |                     |     |    |
|   |   | Start |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 6\)   |                    |                     | \$  |    |
|   |   | EMSC  |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 7\)   |                    |                     | \$  |    |
|   |   | Bi    |                    |                     |     |    |
|   |   | oterr |                    |                     |     |    |
|   |   | orism |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 8\)   |                    |                     | \$  |    |
|   |   | Trau  |                    |                     |     |    |
|   |   | matic |                    |                     |     |    |
|   |   | Brain |                    |                     |     |    |
|   |   | I     |                    |                     |     |    |
|   |   | njury |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 9\)   |                    |                     | \$  |    |
|   |   | State |                    |                     |     |    |
|   |   | Title |                    |                     |     |    |
|   |   | V     |                    |                     |     |    |
|   |   | Block |                    |                     |     |    |
|   |   | Grant |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 10\)  |                    |                     | \$  |    |
|   |   | O     |                    |                     |     |    |
|   |   | ther: |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | O |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | h |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | H |       |                    |                     |     |    |
|   | R |       |                    |                     |     |    |
|   | S |       |                    |                     |     |    |
|   | A |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 1\)   |                    |                     | \$  |    |
|   |   | HIV   |                    |                     |     |    |
|   |   | /AIDS |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 2\)   |                    |                     | \$  |    |
|   |   | Pr    |                    |                     |     |    |
|   |   | imary |                    |                     |     |    |
|   |   | Care  |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 3\)   |                    |                     | \$  |    |
|   |   | H     |                    |                     |     |    |
|   |   | ealth |                    |                     |     |    |
|   |   | P     |                    |                     |     |    |
|   |   | rofes |                    |                     |     |    |
|   |   | sions |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 4\)   |                    |                     | \$  |    |
|   |   | O     |                    |                     |     |    |
|   |   | ther: |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   | O |       |                    |                     |     |    |
|   | t |       |                    |                     |     |    |
|   | h |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | e |       |                    |                     |     |    |
|   | r |       |                    |                     |     |    |
|   | a |       |                    |                     |     |    |
|   | l |       |                    |                     |     |    |
|   | F |       |                    |                     |     |    |
|   | u |       |                    |                     |     |    |
|   | n |       |                    |                     |     |    |
|   | d |       |                    |                     |     |    |
|   | s |       |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 1\)   |                    |                     | \$  |    |
|   |   | CMS   |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 2\)   |                    |                     | \$  |    |
|   |   | SSI   |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 3\)   |                    |                     | \$  |    |
|   |   | A     |                    |                     |     |    |
|   |   | gricu |                    |                     |     |    |
|   |   | lture |                    |                     |     |    |
|   |   | (     |                    |                     |     |    |
|   |   | WIC/o |                    |                     |     |    |
|   |   | ther) |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 4\)   |                    |                     | \$  |    |
|   |   | ACF   |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 5\)   |                    |                     | \$  |    |
|   |   | CDC   |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 6\)   |                    |                     | \$  |    |
|   |   | S     |                    |                     |     |    |
|   |   | AMHSA |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 7\)   |                    |                     | \$  |    |
|   |   | NIH   |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+
|   |   | 8\)   |                    |                     | \$  |    |
|   |   | Educ  |                    |                     |     |    |
|   |   | ation |                    |                     |     |    |
+---+---+-------+--------------------+---------------------+-----+----+

  -------- --------------- -------- --------------------- ---------------------- ------ -----
                           9\)                                                   \$     
                           Other:                                                       

                                                                                 \$     

                                                                                 \$     

  **7.**   **TOTAL                                                               \$     
           COLLABORATIVE                                                                
           FEDERAL FUNDS**                                                              
  -------- --------------- -------- --------------------- ---------------------- ------ -----

**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 SF-424 R&R in addition to this form.

**FORM 2**

**PROJECT FUNDING PROFILE**

<table style="width:100%;">
<colgroup>
<col style="width: 1%" />
<col style="width: 11%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 6%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
<col style="width: 1%" />
<col style="width: 7%" />
</colgroup>
<tbody>
<tr class="odd">
<td></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
<td></td>
<td colspan="3"><u>FY_____</u></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
<td></td>
<td><u>Budgeted</u></td>
<td></td>
<td><u>Expended</u></td>
</tr>
<tr class="odd">
<td><strong>1</strong></td>
<td><p><u>MCHB Grant</u></p>
<p><u>Award</u> <u>Amount</u></p>
<p><em>Line 1, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>2</strong></td>
<td><p><u>Unobligated Balance</u></p>
<p><em>Line 2, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="odd">
<td><strong>3</strong></td>
<td><p><u>Matching Funds</u></p>
<p><u>(If required)</u></p>
<p><em>Line 3, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>4</strong></td>
<td><p><u>Other Project Funds</u></p>
<p><em>Line 4, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="odd">
<td><strong>5</strong></td>
<td><p><u>Total Project Funds</u></p>
<p><em>Line 5, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
<tr class="even">
<td><strong>6</strong></td>
<td><p><u>Total Federal Collaborative Funds</u></p>
<p><em>Line 7, Form 2</em></p></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
<td></td>
<td><strong>$</strong></td>
</tr>
</tbody>
</table>

**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.

**FORM 4**

**PROJECT BUDGET AND EXPENDITURES**

**By Types of Services**

+---+------------------------+--------+---+--------+---+--------+---+--------+
|   |                        | **FY   |   |        |   | **FY   |   |        |
|   |                        | \_\_\_ |   |        |   | \_\_\_ |   |        |
|   |                        | \_\_** |   |        |   | \_\_** |   |        |
+---+------------------------+--------+---+--------+---+--------+---+--------+
|   | **[TYPES OF            | **     |   | **     |   | **     |   | **     |
|   | S                      | [Budge |   | [Expen |   | [Budge |   | [Expen |
|   | ERVICES]{.underline}** | ted]{. |   | ded]{. |   | ted]{. |   | ded]{. |
|   |                        | underl |   | underl |   | underl |   | underl |
|   |                        | ine}** |   | ine}** |   | ine}** |   | ine}** |
+---+------------------------+--------+---+--------+---+--------+---+--------+
| * | **[Direct Health Care  | \$     |   | \$     |   | \$     |   | \$     |
| * | S                      |        |   |        |   |        |   |        |
| I | ervices]{.underline}** |        |   |        |   |        |   |        |
| . |                        |        |   |        |   |        |   |        |
| * | (Basic Health Services |        |   |        |   |        |   |        |
| * | and                    |        |   |        |   |        |   |        |
|   |                        |        |   |        |   |        |   |        |
|   | Health Services for    |        |   |        |   |        |   |        |
|   | CSHCN.)                |        |   |        |   |        |   |        |
+---+------------------------+--------+---+--------+---+--------+---+--------+
| * | **[Enabling            | \$     |   | \$     |   | \$     |   | \$     |
| * | S                      |        |   |        |   |        |   |        |
| I | ervices]{.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    | \$     |   | \$     |   | \$     |   | \$     |
| * | S                      |        |   |        |   |        |   |        |
| I | ervices]{.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 | S                      |        |   |        |   |        |   |        |
| V | ervices]{.underline}** |        |   |        |   |        |   |        |
| . |                        |        |   |        |   |        |   |        |
| * | (Needs Assessment,     |        |   |        |   |        |   |        |
| * | Evaluation, Planning,  |        |   |        |   |        |   |        |
|   | Policy Development,    |        |   |        |   |        |   |        |
|   | Coordination, Quality  |        |   |        |   |        |   |        |
|   | Assurance, Standards   |        |   |        |   |        |   |        |
|   | Development,           |        |   |        |   |        |   |        |
|   |                        |        |   |        |   |        |   |        |
|   | Monitoring, Training,  |        |   |        |   |        |   |        |
|   | Applied Research,      |        |   |        |   |        |   |        |
|   | Systems of Care, and   |        |   |        |   |        |   |        |
|   | Information Systems.)  |        |   |        |   |        |   |        |
+---+------------------------+--------+---+--------+---+--------+---+--------+
| * | ######### **TOTAL**    | \$     |   | \$     |   | \$     |   | \$     |
| * |                        |        |   |        |   |        |   |        |
| V |                        |        |   |        |   |        |   |        |
| . |                        |        |   |        |   |        |   |        |
| * |                        |        |   |        |   |        |   |        |
| * |                        |        |   |        |   |        |   |        |
+---+------------------------+--------+---+--------+---+--------+---+--------+

**INSTRUCTIONS FOR THE COMPLETION OF FORM 4**

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

Complete all required data cells for all years of the g rant. 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.

FORM 6 MATERNAL & CHILD HEALTH DISCRETIONARY GRANT

**PROJECT ABSTRACT**

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

**PROJECT:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

**I. PROJECT IDENTIFIER INFORMATION**

1\. Project Title:

2\. Project Number:

3\. E-mail address:

**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. TYPE(S) OF SERVICE PROVIDED (Choose all that apply)**

\[ \] Direct Health Care Services

> \[ \] Enabling Services
>
> \[ \] Population-Based Services
>
> \[ \] Infrastructure Building Services

**IV. PROJECT DESCRIPTION OR EXPERIENCE TO DATE**

> A. Project Description

1.  Problem (in 50 words, maximum):

2.  Goals and Objectives: (List up to 5 major goals and time-framed
    objectives per goal for the project)

> Goal 1:

Objective 1:

Objective 2:

Goal 2:

Objective 1:

Objective 2:

Goal 3:

Objective 1:

Objective 2:

Goal 4:

Objective 1:

Objective 2:

Goal 5:

Objective 1:

Objective 2:

3.  Activities undertaken to meet project goals

4.  Specify the primary *Healthy People 2010* objectives(s) (up to
    three) which this project addresses:

> a\.
>
> b\.
>
> c\.

5\. Coordination (List the State, local health agencies or other
organizations involved in the project and their roles)

6\. Evaluation (briefly describe the methods which will be used to
determine whether process and outcome objectives are met)

*V. KEY WORDS*

*VI. ANNOTATION*

> **INSTRUCTIONS FOR THE COMPLETION OF FORM 6**

**PROJECT ABSTRACT**

**NOTE:** All information provided should fit into the space provided in
the form. The completed form should be no more than 3 pages in length.
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**

Project Title: List the appropriate shortened title for the project.

Project Number: This is the number assigned to the project when funded,
and will, for new projects, be filled in later.

E-mail address: Include electronic mail addresses

**Section II -- Budget - These figures will be transferred from Form 1,
Lines 1 through 5.**

**Section III - Types of Services**

> Indicate which type(s) of services your project provides, checking all
> that apply (consistent with Form 5)

**Section IV -- Program Description OR Current Status (DO NOT EXCEED THE
SPACE PROVIDED)**

A. New Projects only are to complete the following items:

1.  A brief description of the project and the problem it addresses such
    as preventive and primary care services for pregnant women, mothers,
    and infants; preventive and primary care services for children; and
    services for Children with Special Health Care Needs.

2.  Up to 5 goals of the project, in priority order. Examples are: To
    reduce the barriers to the delivery of care for pregnant women, to
    reduce the infant mortality rate for minorities and "services or
    system development for children with special healthcare needs." MCHB
    will capture annually every project's top goals in an information
    system for comparison, tracking, and reporting purposes; you must
    list at least 1 and no more than 5 goals. For each goal, list the
    two most important objectives. The objective must be specific (i.e.,
    decrease incidence by 10%) and time limited (by 2007).

3.  List the primary Healthy people 2010 goal(s) that the project
    addresses.

4.  Describe the programs and activities used to attain the goals and
    objectives, and comment on innovation, cost, and other
    characteristics of the methodology, proposed or are being
    implemented. Lists with numbered items can be used in this section.

5.  Describe the coordination planned and carried out, in the space
    provided, if applicable, with appropriate State and/or local health
    and other agencies in areas(s) served by the project.

6.  Briefly describe the evaluation methods that will be used to assess
    the success of the project in attaining its goals and objectives.

**Section V - -Key Words**

Key words describe the project, including populations served. Choose key
words from the included list.

**Section VI -- 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.

FORM 7 DISCRETIONARY GRANT PROJECT

> **SUMMARY DATA**

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 Agency

\[ \] Community Government Agency

\[ \] 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

**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.