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

**Health Resources and Services Administration**

*Office of Rural Health Policy*

*Radiation Exposure Screening and Education Program (RESEP)*

> *Radiation Exposure Screening and Education Program (RESEP)*
>
> *New Grant Competition*
>
> ***HRSA-08-063***
>
> **Catalog of Federal Domestic Assistance (CFDA) No. 93.257**

**PROGRAM GUIDANCE**

Fiscal Year *2008*

**Application Due Date: March 20, 2008**

**Release Date: *January 4, 2008***

**Date of Issuance*: January 4, 2008 ***

> Contact Name: Vanessa Hooker
>
> Program Coordinator, RESEP Program
>
> HRSA's Office of Rural Health Policy
>
> Telephone: 301-594-5105

Fax: 301-443-2803

Authority: Section 417C of the Public Health Service Act, (42 USC
285(a)-9)

**Guidance Table of Contents**

[I. Funding Opportunity Description 2](#__RefHeading___Toc183319061)

[Purpose 2](#Funding_purpose)

[Background 2](#__RefHeading___Toc183319063)

[II. Award Information 2](#__RefHeading___Toc183319064)

[1. Type of Award 2](#__RefHeading___Toc183319065)

[2. Summary of Funding 2](#__RefHeading___Toc183319066)

[III. Eligibility Information 2](#__RefHeading___Toc183319067)

[1. Eligible Applicants 2](#Eligibility_who)

[2. Cost Sharing/Matching 2](#__RefHeading___Toc183319069)

[3. Other 2](#__RefHeading___Toc183319070)

[IV. Application and Submission Information
2](#__RefHeading___Toc183319071)

[1. Address to Request Application Package 2](#Application_materials)

[Application Materials 2](#__RefHeading___Toc183319073)

[2. Content and Form of Application Submission
2](#__RefHeading___Toc183319074)

[Application Format Requirements 2](#Application_formatrequirements)

[i. Application Face Page 2](#__RefHeading___Toc183319076)

[ii. Table of Contents 2](#__RefHeading___Toc183319077)

[iii. Application Checklist 2](#__RefHeading___Toc183319078)

[iv. Budget 2](#__RefHeading___Toc183319079)

[v. Budget Justification 2](#__RefHeading___Toc183319080)

[vi. Staffing Plan and Personnel Requirements
2](#__RefHeading___Toc183319081)

[vii. Assurances 2](#__RefHeading___Toc183319082)

[viii. Certifications 2](#__RefHeading___Toc183319083)

[ix. Project Abstract 2](#__RefHeading___Toc183319084)

[x. Program Narrative 2](#__RefHeading___Toc183319085)

[xi. Program Specific Forms, if applicable
2](#__RefHeading___Toc183319086)

[xii. Attachments 2](#Format_ProgramSpecificForms)

[3. Submission Dates and Times 2](#__RefHeading___Toc183319088)

[i. Application Due Date 2](#Application_intent)

[ii. Late applications: 2](#__RefHeading___Toc183319090)

[4. Intergovernmental Review 2](#Application_materials)

[5. Funding Restrictions 2](#Application_fundingrestrictions)

[6. Other Submission Requirements 2](#__RefHeading___Toc183319093)

[V. Application Review Information 2](#__RefHeading___Toc183319094)

[1. Review Criteria 2](#Review_ReviewCriteria)

[2. Organizational Capabilities and Expertise
2](#organizational-capabilities-and-expertise)

[3. Readiness 2](#readiness)

[4. Input from Program Users 2](#input-from-program-users)

[5. Health Care Plan 2](#health-care-plan)

[6. Business Plan 2](#business-plan)

[2. Review and Selection Process 2](#__RefHeading___Toc183319101)

[3. Anticipated Announcement and Award Dates
2](#__RefHeading___Toc183319102)

[VI. Award Administration Information 2](#__RefHeading___Toc183319103)

[1. Award Notices 2](#Award_PostAwardNotice)

[2. Administrative and National Policy Requirements
2](#__RefHeading___Toc183319105)

[3. Reporting 2](#Award_OtherReportingRequirements)

[VII. Agency Contacts 2](#__RefHeading___Toc183319107)

[VIII. Other Information 2](#__RefHeading___Toc183319108)

[APPENDIX A: HRSA's Electronic Submission User Guide
2](#__RefHeading___Toc183319109)

[1. Introduction 2](#introduction)

[1.1 Document Purpose and Scope 2](#document-purpose-and-scope)

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

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

[2.1 Process Overview 2](#process-overview)

[2.2 Grantee Organization Needs to Register With Grants.gov (if not
already registered) -- See Appendix B
2](#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)
2](#project-director-and-authorizing-official-need-to-register-with-hrsa-ehbs-if-not-already-registered)

[2.4 Apply through Grants.gov 2](#apply-through-grants.gov)

[2.4.1 Find Funding Opportunity 2](#find-funding-opportunity)

[2.4.2 Download Application Package 2](#download-application-package)

[2.4.3 Complete Application 2](#complete-application)

[2.4.4 Submit Application 2](#submit-application)

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

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

[2.5.1 Verify Status of Application 2](#verify-status-of-application-1)

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

[2.5.3 Check Validation Errors 2](#check-validation-errors)

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

[2.5.5 Submit Application 2](#submit-application-1)

[3. Competing Application 2](#competing-application)

[3.1 Process Overview 2](#process-overview-1)

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

[3.3 Apply through Grants.gov 2](#apply-through-grants.gov-1)

[3.3.1 Find Funding Opportunity 2](#find-funding-opportunity-1)

[3.3.2 Download Application Package 2](#download-application-package-1)

[3.3.3 Complete Application 2](#complete-application-1)

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

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

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

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

[4.1.1 Font 2](#font)

[4.1.2 Paper Size and Margins 2](#paper-size-and-margins)

[4.1.3 Names 2](#names)

[4.1.4 Section Headings 2](#section-headings)

[4.1.5 Page Numbering 2](#page-numbering)

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

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

[4.3 Page Limit 2](#page-limit)

[5. Customer Support Information 2](#customer-support-information)

[5.1.1 Grants.gov Customer Support 2](#grants.gov-customer-support)

[5.1.2 HRSA Call Center 2](#hrsa-call-center)

[5.1.3 HRSA Program Support 2](#hrsa-program-support)

[6. FAQs 2](#faqs)

[6.1 Software 2](#software)

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

[6.1.2 Why can't I download PureEdge Viewer onto my machine?
2](#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?
2](#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?
2](#what-are-the-software-requirements-for-hrsa-ehbs)

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

[6.2 Application Receipt 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?
2](#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?
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?
2](#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\"?
2](#if-a-resubmission-is-required-because-of-grants.gov-system-problems-will-these-be-considered-late)

[6.3 Application Submission 2](#application-submission)

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

[6.4 Grants.gov 2](#grants.gov)

[Appendix B -- Registering and Applying Through Grants.gov
2](#__RefHeading___Toc183319167)

[]{#__RefHeading___Toc183319061 .anchor}**I. Funding Opportunity
Description**

[]{#Funding_purpose .anchor}

**[Purpose]{.smallcaps}**

> Section 417C of the Public Health Service Act, as amended, authorizes
> the Secretary of Health and Human Services, acting through the
> Administrator of the Health Resources and Services Administration
> (HRSA), to make grants to eligible entities for the purpose of
> carrying out programs to: develop education programs; disseminate
> information on radiogenic diseases and the importance of early
> detection; screen eligible individuals for cancer and other radiogenic
> diseases; provide appropriate referrals for medical treatment; and
> facilitate documentation of Radiation Exposure Compensation Act (RECA)
> claims. This grant program was developed in consultation with the
> National Institutes of Health (NIH) and Indian Health Service (IHS).
> Within HRSA, the Office of Rural Health Policy administers the
> program, hereinafter referred to as the Radiation Exposure Screening
> and Education Program (RESEP).

[]{#__RefHeading___Toc183319063 .anchor}**[Background]{.smallcaps}**

> From 1945 through 1962, the United States conducted a series of
> aboveground nuclear arms tests. People were exposed to radiation
> resulting from the nuclear arms testing. The people exposed included
> those who participated onsite in a test involving the atmospheric
> detonation of a nuclear device within the official boundaries of the
> Nevada or Trinity Test Sites; and those who were physically present in
> one of the affected areas downwind of the Nevada Test Site. In
> addition, uranium mine employees were exposed to large doses of
> radiation and other airborne hazards in the mine environment that
> together are presumed to have produced an increased incidence of lung
> cancer and respiratory diseases among these mine workers.
>
> RECA Amendments of 2000 amended Subpart I of Part C of Title IV of the
> Public Health Service Act to add section 417C, Grants for Education,
> Prevention, and Early Detection of Radiogenic Cancers and Diseases.
> Section 417C authorizes grants to states, local governments and other
> eligible organizations to initiate and support programs for:
> individual cancer screening; appropriate referrals for medical
> treatment of individuals screened; public information development and
> dissemination; and the facilitation of RECA claims documentation to
> aid the thousands of individuals adversely affected by the mining,
> transport and processing of uranium, and the testing of nuclear
> weapons for the Nation's weapons arsenal (See Section X for RECA
> Definitions, Eligibility and Screening).

The Health Resources and Services Administration's Office of Rural
Health Policy is the focal point for rural health activities within the
U.S. Department of Health and Human Services. The Office is statutorily
required in Title VII (Section 711) of the Social Security Act to advise
the Secretary on the effects of current policies and regulatory changes
in the programs established under titles XVIII (Medicare) and XIX
(Medicaid) on the financial viability of small rural hospitals, the
ability of rural areas to attract and retain physicians and other health
professionals and access to (and the quality of) health care in rural
areas. The Social Security Act also requires ORHP to coordinate
activities within HHS that relate to rural health care and provide
relevant information to the Secretary and others in the Department. ORHP
accomplishes this mission through two broad strategies that focus on
policy and programs. The Office addresses the specific difficulties of
providing health care in rural communities through its grant programs.
The CFDA number for this grant program is 93.257. The RESEP Grant
Program is authorized by the Public Health Service Act Part C of Title
IV, Public Law 106-245 (42 USC 285(a)-9).

> The RESEP encourages and supports appropriate healthcare organizations
> to improve the knowledge base and health status of persons, who were
> adversely affected by the mining, milling, or transporting of uranium
> and the testing of nuclear weapons for the Nation's weapons arsenal.

[]{#__RefHeading___Toc183319064 .anchor}**II. Award Information**

[]{#__RefHeading___Toc183319065 .anchor}**[1. Type of
Award]{.smallcaps}**

Funding will be provided in the form of a grant.

[]{.mark}

[]{#__RefHeading___Toc183319066 .anchor}**[2. Summary of
Funding]{.smallcaps}**

[]{.mark}

> This program will provide funding for Federal fiscal years (FY) 2008
> -2010. Approximately \$1,540,000 is expected to be available annually
> to fund (6-8) grantees. Funding beyond the first year is dependent on
> the availability of appropriated funds for RESEP in subsequent fiscal
> years, grantee satisfactory performance, and a decision that funding
> is in the best interest of the Federal government.

[]{#__RefHeading___Toc183319067 .anchor}**III. Eligibility Information**

[]{#Eligibility_who .anchor}

**[1. Eligible Applicants]{.smallcaps}**

The following entities are eligible to apply for the funds described in
this guidance:

-   National Cancer Institute-designated cancer centers;

-   Department of Veterans' Affairs hospitals or medical centers;

-   Federally Qualified Health Centers (FQHC) (e.g., Section 330 of the
    Public Health Service Act, including: Community Health Centers,
    Migrant Health Centers, and Public Housing Centers), FQHC
    Look-Alikes, or hospitals;

-   Agencies of any State or local government that currently provides
    direct health care services;

-   IHS health care facilities, including programs provided through
    tribal contracts, compacts, grants, or cooperative agreements with
    the IHS and which are determined appropriate to raising the health
    status of Indians; and

-   Nonprofit organizations, including faith-based organizations.

-   Only organizations located in the high-impact States cited in the
    Radiation Exposure Compensation Act (P.L. 106-245); i.e., Arizona,
    Colorado, Idaho, Nevada, New Mexico, North Dakota, Oregon, South
    Dakota, Texas, Utah, Washington, or Wyoming are eligible to apply.

    []{#__RefHeading___Toc183319069 .anchor}**[2. Cost
    Sharing/Matching]{.smallcaps}**

There is no cost sharing or matching requirement for this program.

[]{#__RefHeading___Toc183319070 .anchor}**[3. Other]{.smallcaps}**

Applications that exceed the ceiling amount of \$300,000 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.

A successful applicant measures effectiveness and quality of services
and continuously evolves their programs to achieve the greatest impact.
A successful RESEP applicant collaborates with other organizations;
while maintaining the integrity of federally funded programs by
continuing to fulfill the mission, and comply with applicable laws,
regulations and program expectations.

Applicants must provide a detailed description of a program designed
to: 1) determine individuals' basic eligibility to apply for RECA
compensation; 2) screen patients for radiogenic cancers and diseases; 3)
provide further testing and/or referrals, as indicated, for the
diagnosis and treatment of patients screened; and 4) develop and
disseminate public information and education programs for the detection,
screening, prevention and treatment of radiogenic cancers and diseases.
This is considered as part of the Need and Response review criteria as
specified in Section V.1.

Each applicant must propose a program that includes the following
elements:

-   Outreach

-   Education

-   Medical Screening

-   Depression Screening

-   Diagnostic Testing

-   Referrals

-   RECA Eligibility Assistance

Outreach, Education, Medical and Depression Screening, Diagnostic
Testing, Referrals and RECA Eligibility Assistance are considered as
part of the Response review criteria as specified in Section V.1. Each
of these elements is described below.

Outreach

Each applicant must conduct outreach activities designed to inform the
public of services available through the program. Efforts must be made
to locate and attract as many eligible individuals in the applicant's
service area as possible. Outreach activities may include radio,
television, print media, public announcements, community
meetings/events, direct contact with individuals, and any other suitable
forms of communication.

Education

Each applicant must develop and conduct an education program to
disseminate public information on the detection, prevention, and
treatment of radiogenic cancers and other radiogenic disease, which
should include at least the following elements:

-   Early warning symptoms of the disease

-   Disease processes and causation

-   Frequency of screening

-   Specific preventive and self-care procedures, including smoking
    cessation, proper nutrition, weight control, and exercise

-   Where and when to report to a physician or a nurse to obtain
    screening and medical intervention

-   Available compensation programs

The education component of the proposed program should strive to
establish a close rapport with the community and reach the majority of
eligible individuals in the state or service delivery area. Educational
materials that are distributed must reflect the current state of
scientific knowledge about radiogenic diseases.

Medical Screening

Program applicants must develop standards for screening patients at risk
of developing cancers and other diseases as a result of the exposure to
radiation. The US Preventive Services Task Force (USPSTF) at the Agency
for Healthcare Research and Quality is recognized as the "gold standard
for clinical preventative services." It is recommended that the RESEP
medical screening protocols minimally include the USPSTF guidelines for
screening individuals potentially eligible for compensation under RECA
legislation. These guidelines are available online at:
<http://odphp.osophs.dhhs.gov/pubs/guidecps/>. Program applicants are
encouraged to obtain input from oncologists and pulmonologists who
regularly work in consultation with the program. The screening protocols
must include, at a minimum: a medical and occupational history; a
physical and mental health examination by a nurse practitioner,
physician's assistant or a physician; and follow-up and case-management
plans.

Depression Screening

Program applicants must utilize the screening recommendations for
depression established by the US Preventative Services Task Force
(USPSTF) in the "Guide to Clinical Preventive Services." According to
the "Guide to Clinical Preventive Services, depression is a common and
costly mental health problem that is frequently seen in general medical
settings and is present in about 5 to 13% of patients that are seen by
primary care physicians. The prevalence of this condition among the
general population is about 3 to 5%. RESEP clients are thought to be
atypical clients and should be considered by the screening provider to
be of higher risk.

The prevailing standard according to the Agency for Healthcare Research
and Quality, the diagnosis of depression is the opinion of an examining
psychiatrist that a patient's symptoms meet the criteria described in
the fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV). For the RESEP program, the two-question case-finding
instrument is the recommended approach for detecting depression. For the
two-question instrument, a "yes" response to either of the following two
questions is a considered a positive test: (1) During the past month,
have you often been bothered by feeling down, depressed, or hopeless?"
and (2) During the past month, have you often been bothered by little
interest or pleasure in doing things?"

Medical and Occupational History

Providers and clinic staff should be well trained in obtaining an
occupational history. Special knowledge of uranium or metal mining jobs
is desirable. The medical and occupational history should document the
date of exposure(s), place(s) of residence, occupation(s), and place(s)
of employment. A review of symptoms relevant to each organ system (i.e.,
respiratory, circulatory, etc.) should be documented in the medical
record. The provider should be alert to symptoms suggestive of
occupationally-acquired pulmonary and renal diseases and the following
cancers: multiple myeloma, lymphoma, leukemia, thyroid, female or male
breast, esophagus, liver, lung, urinary bladder, kidney, colon, stomach,
pharynx, small intestine, pancreas, bile ducts, gall bladder, salivary
gland, brain, and ovary.

Physical Examination

A complete physical examination should be performed and documented in
the medical record for each patient. The examiner should be alert to any
physical findings that suggest the presence of the aforementioned
cancers and disease.

Follow-up

Programs must ensure follow-up on the patient\'s care. Follow-up
includes such activities as: maintenance of contact with patient via
telephone; reporting of test results to the patient and his/her primary
care physician; and periodic re-evaluation in the clinic.

Case Management

Programs must ensure management of each patient\'s care. Case management
consists of follow-up activities, including but not limited to: (a)
reporting of test results to the patient and their primary care
physician; (b) following-up with patient and specialty provider to
ensure care was received; (c) tracking patient's progress; and (d)
periodically re-evaluating in the clinic. The case manager should ensure
that all operative, consultative, procedural, and pathology reports are
maintained in the patient's medical record as well as all physicians'
hospital and health care facility discharge summaries.

Diagnostic Testing

When the results of a history and physical examination or screening test
suggest the possibility of disease, the program must arrange for further
diagnostic testing. Diagnostic testing procedures may include, but are
not limited to: a chest x-ray (CXR), pulmonary function testing (PFTs),
arterial blood gases (ABGs), laboratory studies, imaging studies,
endoscopies, and biopsies. Based on findings of the history and physical
examination, and other relevant screening tests, these procedures may be
ordered by a licensed medical professional to rule in/out the
possibility of disease.

Referrals for Medical Treatment

The program must demonstrate evidence of formal agreements with
appropriate entities (i.e., hospitals, providers, specialists) to
promptly evaluate and treat patients in the event of a confirmatory
diagnosis of cancer or non-malignant radiogenic disease
(occupationally-acquired pulmonary and renal disease). Patients must
have access to a board-certified oncologist, pulmonologist, and
nephrologist, or at a minimum, a board-certified internist knowledgeable
about and experienced with radiogenic cancers and non-malignant
pulmonary and renal disease.

Referrals for Treatment of Depression

The program must demonstrate evidence of formal referral agreements with
psychiatrists to promptly evaluate and treat patients for depression
according to the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV).

Eligibility Assistance

Each applicant's program must include activities to assist individuals
who may be eligible for compensation under RECA. Each patient should
have his/her health condition assessed to determine the eligibility for
RECA benefits. Each program must help individuals potentially eligible
for RECA benefits with the medical documentation of their condition.
Programs must inform patients about U.S. Department of Justice standards
for eligibility and provide them with assistance in completing the
application forms or explicitly refer them to a place where such
assistance is available. Information on eligibility or compensable
illnesses is available by calling 1-800-729-7327. Applicants must
include in their project the provision of eligibility information from
other programs (such as those administered by the Department of Labor).
Applicants that are not planning to provide these services directly must
have written arrangements with other entities for such assistance with
applications and legal services.

Individuals eligible for RECA compensation are categorized by the nature
of their exposure to radiation as defined by 42 U.S.C. 2210 and Public
Law 106‑245, Radiation Exposure Compensation Act Amendments of 2000,
sections 4(a) (1) (A) (i) and 5(a) (1) (A), and in 28 CFR Part 79 (see
Section X for more in-depth descriptions and definitions). In general,
these categories include:

-   Uranium miners

-   Uranium millers;

-   Ore transporters;

-   Downwinders, i.e., those who were physically present downwind of
    atmospheric nuclear tests; and

-   Onsite participants, i.e., those who participated onsite in a test
    involving the atmospheric detonation of a nuclear device.

######### **Other Program Elements**

1.  Staffing

There must be a licensed physician, physician assistant, or nurse
practitioner on staff. Other professional staff could include:
registered nurses, patient education specialists, case managers, patient
care coordinators, and outreach coordinators. This requirement is
considered as part of the Response review criteria as specified in
Section V.1.

2.  Data Collection

Applicants receiving funding under the RESEP must collect, update, and
maintain demographic and utilization information on each individual seen
by the applicant, including age, gender, race/ethnicity, insurance
status, date and type of exposure, dates and types of screening
procedures done, the dates and types of referrals made (provider
specialty, facility, reason for referral - diagnosis and/or treatment),
and the dates and types of radiogenic cancers diagnosed, and
nonmalignant radiogenic diseases. Data should also be collected
regarding the number of individuals contacted by type of outreach
activity; and the number of individuals receiving a program of education
on the detection, prevention, and treatment of radiogenic cancers and
other radiogenic diseases. Applicants must also maintain the necessary
data systems that are able to track individuals in terms of their
screening, final diagnosis and participation in the RECA compensation
program.

3.  Finance

At a minimum, the program must maintain financial systems that provide
for internal controls, safeguard assets, ensure stewardship of Federal
funds, maintain adequate cash flow to support operations, assure access
to care, and maximize revenue from non-Federal sources. Financial
systems should be routinely reviewed and updated to assure that the
organization remains financially sound, competitive, and aware of
changes in the local, state, and national health care environment.

Grant funds may not be used to supplant other provider/third party
coverage payments available to the patient. Public Law 106-245, Section
417C authorizing RESEP states, "nothing in this section shall be
construed to affect any coverage obligation of a governmental or private
health plan or program relating to an individual referred to under
subsection (b)(1)."

Given the limited availability of Federal resources, an important
component of fulfilling this mandate is the maximization of revenue from
all sources. Revenue maximization requires: an adequate and competitive
fee schedule and a corresponding schedule of discounts; prompt and
accurate billing of third party payers; billing of patients in
accordance with the schedule of discounts; and timely follow-up on all
uncollected amounts. RESEP programs must maximize revenue and
participate in favorable enhanced or cost-based reimbursement programs
for which they are eligible.

The program must ensure that an annual independent financial audit is
performed in accordance with Federal audit requirements at 45 CFR 74.26.
Audits on non-profit organizations must follow the most recent Federal
guidelines pertaining to the auditing of non-profit institutions and,
specifically, to the auditing of recipients of Federal awards to such
institutions. The program should issue a memorandum of engagement for an
annual independent financial audit, which will be performed in
compliance with the applicable Federal guidelines. In addition, the
Financial Status Report (FSR) and reconciliation between the audit and
FSR must be prepared in accordance with 45 CFR 74.52.

4.  Quality Assurance Program

There must be approaches for determining whether all services provided
are effective and in accordance with medical practice standards. A
quality assurance program should be developed that includes the capacity
to: (a) evaluate patient satisfaction and medical error reporting; and
(b) examine access, quality of clinical care, quality of work force,
cost and productivity.

5.  Health Care and Business Plan

All currently funded grantees must include a Health Care and Business
Plan as referenced in Section XIII that explains the progress of the
organization. The report must be concise and should address each of the
goals and objectives as well as the accomplishments to date.

6.  Cultural Proficiency

Organizational behaviors, practices, attitudes, and policies across all
program functions should respect and respond to the dissimilar cultures
of communities and clients served. A successful RESEP applicant develops
systems that ensure participation of these populations. Applicants are
expected to describe a culturally and linguistically proficient service
plan. Although race and ethnicity are often thought to be dominant
elements of culture, RESEP applicants should embrace a broader
definition to include: physical and mental capacity, age, religion,
housing status, language, gender, socio-economic status and regional
differences. RESEP applicants should develop systems that ensure
participation of these aforementioned populations, including, where
appropriate, participation of persons with limited English-speaking
ability, in programs offered by the RESEP.  Applicants are expected to
describe a culturally and linguistically proficient service plan. The
RESEP should also hire culturally and linguistically proficient staff.

[]{#__RefHeading___Toc183319071 .anchor}**IV. Application and Submission
Information**

[]{#Application_materials .anchor}

**[1. Address to Request Application Package]{.smallcaps}**

[]{#__RefHeading___Toc183319073 .anchor}***Application Materials***

> The application and submission process has changed significantly. HRSA
> is ***requiring*** applicants for this funding opportunity to apply
> electronically through Grants.gov. All applicants ***must*** submit in
> this manner unless the applicant is granted a written exemption from
> this requirement in advance by the Director of HRSA's Division of
> Grants Policy. Grantees must request an exemption in writing from
> <DGPWaivers@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 for which you
> are seeking relief. 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.

[]{#__RefHeading___Toc183319074 .anchor}**[2. Content and Form of
Application Submission]{.smallcaps}**

[]{#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.**
>
> **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 pages 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
  Summary/Abstract                 2 of SF-424 - Box 15     attachment. Counted
                                                            in the page limit.
                                                            Refer to guidance
                                                            for detailed
                                                            instructions.
                                                            Provide table of
                                                            contents specific
                                                            to this document
                                                            only as the first
                                                            page

  Additional          Attachment   Can be added on page 2   As applicable to
  Congressional                    of SF 424 - Box 16       HRSA; not counted
  District                                                  in 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
                                   Project Narrative        attachment. Counted
                                   Attachment form.         in the page limit.
                                                            Refer to 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. Some are
                                                            counted in the page
                                                            limit -- see below.
  -----------------------------------------------------------------------------

-   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.

-   Merge similar documents into a single document. Where several pages
    are expected in the attachment, place a table of contents cover page
    specific to that attachment. Table of Contents page will not be
    counted in the page limit.

  -----------------------------------------------------------------------
  **Attachment     **Attachment Description (Program Guidelines)**
  Number**         
  ---------------- ------------------------------------------------------
  Attachment 1     **Copy of Signed SF-424/5161 Face Sheet**

  Attachment 2     **Budget Justification**- Itemized Budget and Budget
                   Narrative: Provide the two components of the budget
                   justification, the itemized budget and budget
                   narrative, for each of funding requested. The itemized
                   budget should be depicted in columns in a table or
                   spreadsheet format to easily depict the line item
                   information to explain the costs entered in the PHS
                   Application Form 5161-1. These figures must match the
                   figures requested for each line in the budget
                   presented on Form 424A. The budget narrative should
                   clearly describe and provide justification for each
                   budget item and how it will support the achievement of
                   proposed objectives during each one-year budget
                   period. This **will count** against the 80-page limit.

  Attachment 3     **Job Descriptions for Key Personnel:** Provide a
                   staffing plan explaining the staffing requirements
                   necessary to complete the project, the qualification
                   levels for the project staff, and rationale for the
                   amount of time requested for each staff position.
                   Provide the job descriptions for key personnel listed
                   in the application that describes the specific roles,
                   responsibilities, and qualifications for each proposed
                   project position. Keep each to one page if possible.
                   For the purposes of this application, key personnel is
                   defined as persons funded by this grant or persons
                   conducting activities central to this grant program.
                   This **will count** against the 80-page limit.

  Attachment 4     **Biographical Sketches of Key Personnel:** Include
                   biographical sketches for persons occupying the key
                   positions described in Attachment 2, not to exceed two
                   pages in length. 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. This
                   **will count** against the 80-page limit.

  Attachment 5     **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 subcontractors
                   and any deliverable. Letters of agreements must be
                   dated. The letters of agreement **will not count**
                   against the 80-page limit.

  Attachment 6     **Project Organizational Chart:** Provide a one-page
                   figure that depicts the organizational structure of
                   the project, including subcontractors and other
                   significant collaborators. This **will count** against
                   the 80-page limit.

  Attachment 7     **Letters of Support and Other Relevant Documents:**
                   Include here any other documents that are relevant to
                   the application, including letters of support. Letters
                   of support and any other optional attachments **will
                   count** against the 80-page limit. 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.
  -----------------------------------------------------------------------

> Note the following specific information related to your submission.

**[Application Format]{.smallcaps}**

i.  []{#__RefHeading___Toc183319076 .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.*257*.
>
> **DUNS Number**
>
> All applicant organizations are required to have a Data Universal
> Numbering System (DUNS) number in order to apply for a grant from the
> Federal Government. The DUNS number is a unique nine-character
> identification number provided by the commercial company, Dun and
> Bradstreet. There is no charge to obtain a DUNS number. Information
> about obtaining a DUNS number can be found at
> <http://www.hrsa.gov/grants/dunsccr.htm> or call 1-866-705-5711.
> Please include the DUNS number -- in item 8c on the application face
> page. Applications ***will not*** be reviewed without a DUNS number.
>
> Additionally, the applicant organization is required to register with
> the Federal Government's Central Contractor Registry (CCR) in order to
> do electronic business with the Federal Government. Information about
> registering with the CCR can be found at
> <http://www.hrsa.gov/grants/dunsccr.htm>.

ii. []{#__RefHeading___Toc183319077 .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___Toc183319078 .anchor}***Application Checklist***

> Application Form 5161-1 provided with the application package.

iv. []{#__RefHeading___Toc183319079 .anchor}***Budget***

> Application Form 5161-1 provided with the application package.

v.  []{#__RefHeading___Toc183319080 .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 or more) at the time of application. Line
> item information must be provided to explain the costs entered in
> appropriate form 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 project periods up to
> three years. Awards, on a competitive basis, will be for a one‑year
> budget period, although project periods may be for three years.
> Applications for continuation grants funded under these awards beyond
> the one-year budget period but within the three 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.
>
> *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 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.*
>
> ***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 participation in a two-day post-award meeting to be
> held in Washington, D.C. (dates to be determined) and other proposed
> trainings or workshops.*
>
> ***Equipment**: List equipment costs and provide justification for the
> need of the equipment to carry out the program's goals. Extensive
> justification and a detailed status of current equipment must be
> provided when requesting funds for the purchase of computers and
> furniture items that meet the Federal* d*efinition of equipment (a
> unit cost of \$5000 and a useful life of one or more years).*
>
> ***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 an explanation of each cost in this
> category. In some cases, grantee rent, utilities and insurance fall
> under this category if they are not included in an approved indirect
> cost rate.)*

vi. []{#__RefHeading___Toc183319081 .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 in Attachment 3. Copies of biographical sketches for any key
> employed personnel that will be assigned to work on the proposed
> project must be included in Attachment *4*.

vii. []{#__RefHeading___Toc183319082 .anchor}***Assurances***

> Application Form 5161-1 provided with the application package.

viii. []{#__RefHeading___Toc183319083 .anchor}***Certifications***

> Application Form 5161-1 provided with the application package.

ix. []{#__RefHeading___Toc183319084 .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.
>
> *Please place the following at the top of the abstract:*

-   *Project Title*

-   *Applicant Name*

-   *Address*

-   *Contact Phone Numbers (Voice, Fax)*

-   *E-Mail Address*

-   *Web Site Address, if applicable*

> The project abstract must be single-spaced and limited to one page in
> length. The project abstract should be attached in Box 15, Descriptive
> Title of Applicants Project on the SF 424 face page. From Box 15,
> click "add attachments" and follow the instructions. When finished,
> click "attach" and "done."

i.  []{#__RefHeading___Toc183319085 .anchor}***Program Narrative***

> The Program Narrative should provide a comprehensive framework and
> description of all aspects of the proposed program(s). It should be
> succinct, self-explanatory and well organized so that reviewers can
> understand the proposed program. The Program Narrative should be a
> **detailed** description of the service area/target population to be
> served, the applicant organization and its administrative/fiscal plan
> for addressing the identified health care needs/issues of the service
> area/target population. In general, the description includes: an
> assessment of the health of the service area/target population;
> radiogenic factors responsible for this state of health; community
> resources available to meet needs; an assessment of what is currently
> being done in the service area to address major health issues,
> including how the organization integrates its approach with other
> efforts in the service area to meet these needs; and the applicant's
> plan to address these needs and integrate its approach with other
> efforts in the service area. Successful applicants will fully address
> each of the following items listed under the appropriate opportunity,
> using the following section headers as indicated:

-   Introduction

-   Need

-   Resources/Capabilities

-   Response

-   Support requested

-   Evaluative Measures

-   Impact

During the review process, applications will be assessed based on how
well they address each item requested in the Program Narrative
guidelines. The maximum points that may be assigned (out of 100 possible
points) are also indicated after each heading/subheading (the main
Review Criteria). For further information about the Review Criteria and
the review process, see: Section V Application Review Information.

> []{.mark}

i.  []{#__RefHeading___Toc183319086 .anchor}***Program Specific Forms,
    if applicable***

> []{#Format_ProgramSpecificForms .anchor}

ii. ***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.
>
> Attachment 1: Copy of signed SF-424/5161 Face Page
>
> Attachment 2: Budget Justification -- Itemized Budget and Budget
> Narrative: Provide the two components of the budget justification, the
> itemized budget and budget narrative, for each year of funding
> requested. The itemized budget should be depicted in columns in a
> table or spreadsheet format to easily depict the line item information
> to explain the costs entered in the PHS Application Form 5161-1. These
> figures must match the figures requested for each line in the budget
> presented on Form 424A. The budget narrative should clearly describe
> and provide justification for each budget item and how it will support
> the achievement of proposed objectives during each one-year budget
> period. This **will count** against the 80-page limit.

[]{.mark}

> Attachment 3: Job Descriptions for Key Personnel: Provide a staffing
> plan explaining the staffing requirements necessary to complete the
> project, the qualification levels for the project staff, and rationale
> for the amount of time requested for each staff position. Provide the
> job descriptions for key personnel listed in the application that
> describes the specific roles, responsibilities, and qualifications for
> each proposed project position. Keep each to one page if possible. For
> the purposes of this application, key personnel is defined as persons
> funded by this grant or persons conducting activities central to this
> grant program. This **will count** against the 80-page limit.

[]{.mark}

> Attachment 4: Biographical Sketches of Key Personnel: Include
> biographical sketches for persons occupying the key positions
> described in Attachment 3, not to exceed two pages in length. 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. This will count against
> the 80-page limit.

[]{.mark}

> Attachment 5: 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 subcontractors and any deliverable. Letters of agreements
> must be dated. The letters of agreement will not count against the
> 80-page limit.

[]{.mark}

> Attachment 6: Project Organizational Chart: Provide a one-page figure
> that depicts the organizational structure of the project, including
> subcontractors and other significant collaborators. This **will
> count** against the 80-page limit.

[]{.mark}

> Attachment 7: Letters of Support and Other Relevant Documents: Include
> here any other documents that are relevant to the application,
> including letters of support. Letters of support and any other
> optional attachments will count against the 80-page limit. 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.
>
> **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.**

[]{.mark}

[]{#__RefHeading___Toc183319088 .anchor}**[3. Submission Dates and
Times]{.smallcaps}**

[]{#Application_intent .anchor}

i.  ***Application Due Date***

> The due date for applications under this grant announcement is March
> 20, 2008 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.**

ii. []{#__RefHeading___Toc183319090 .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. Intergovernmental Review]{.smallcaps}**

**The Radiation Exposure Screening and Education (RESEP)** is a program
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.

[]{#Application_fundingrestrictions .anchor}

**[5. Funding Restrictions]{.smallcaps}**

> Applicants responding to this announcement may request funding for a
> project period of up to 3 years at no more than \$300,000 per year.
> 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.
>
> []{.mark}

[]{#__RefHeading___Toc183319093 .anchor}**[6. Other Submission
Requirements]{.smallcaps}**

> 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. You must, however, ensure that a copy of the
> SF-424/5161 Face Sheet is printed, [signed]{.underline}, scanned, and
> included with your electronic application submission as Attachment 1.
>
> 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 included in the electronic application submission.
>
> **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.
> Further information on the HRSA electronic submission policy can be
> obtained at <http://www.hrsa.gov/grants/electronicsubmission.htm>.**

[]{#__RefHeading___Toc183319094 .anchor}**V. Application Review
Information**

[]{#Review_ReviewCriteria .anchor}

**[1. Review Criteria]{.smallcaps}**

> 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.
>
> The RESEP has six Review Criteria - Need, Resources/Capabilities,
> Response, Support Requested, Evaluative Measures, and Impact.
> Reviewers will assign points based on how well the application has
> addressed each of the requested items in the Program Narrative section
> of this guidance. In addition, Support Requested is a Review Criterion
> that considers the reasonableness of the proposed Budget (including
> Budget Justification) in relation to the objectives, the complexity of
> the activities, and the anticipated results.

**The maximum review criteria points awarded for the RESEP are presented
below:**

> A. Need -- 10 Points
>
> B. Resources/Capabilities -- 10 Points
>
> C. Response -- 60 Points
>
> D. Support Requested --10 Points
>
> E. Evaluation Measures -- 5 Points
>
> F. Impact -- 5 Points

*Applicants should pay strict attention to addressing all these
criteria, as they are the basis upon which the reviewers will evaluate
their application*.

Use the following section headers for the Narrative:

**INTRODUCTION (0 points):**

This section should briefly describe the purpose of the proposed
program.

**A. NEED (10 points maximum):** **Description of the Population**

a.  Identify the individuals to be served.

b.  Provide a description of the service area (identify counties or
    census tracts, as appropriate) and target population. Include
    reliable data on the population of eligible individuals who will be
    educated and screened, and with whom you will perform appropriate
    follow-up. Cite sources of data or estimates.

c.  Describe unique characteristics of the service area/target
    population and health indicators (e.g., local mines, test sites, or
    reservations). Describe a specific geographic area where a
    significant number of eligible individuals are located.

d.  Identify and describe the health care providers that will be
    committed to serving the population in this program and provide
    letters or memoranda of agreement or contracts that documents
    providers' commitment of resources (e.g., funds, services,
    personnel, facilities) that will augment Federal grant funds.

e.  Describe the target population and its need for RESEP-related health
    services, using information on race, ethnicity, age/sex breakdown,
    primary languages, income distribution, medical insurance coverage
    rates, and the presence of other special populations (e.g., Medicaid
    participation rate, active, former, and retired uranium miners,
    persons who were adversely affected by the mining, milling, or
    transporting of uranium and the testing of nuclear weapons for the
    Nation's weapons arsenal). The information must demonstrate a
    critical mass of persons in need of RESEP services.

f.  Describe the health status and treatment needs of the target
    population including perceived and tangible barriers to accessing
    RESEP services (e.g., cultural or language issues, access issues
    related to managed care or reimbursement, lack of health care
    providers with expertise in diagnosing managing and rehabilitating
    patients with radiogenic-related diseases, inability to access
    facilities with the appropriate diagnostic and rehabilitative
    equipment) and other unique or special treatment needs or service
    delivery considerations for the populations to be served.

g.  Describe how the target population currently accesses
    radiogenic-related services. Include data to support an assessment
    that even with an efficient program, there is unmet demand for RESEP
    services at the site.

h.  Identify the type of patients, e.g., uranium miners, millers, ore
    transporters, individuals who were physically present in affected
    areas, individuals who participated onsite in a test involving the
    atmospheric detonations of a nuclear device) within the proposed
    service area.

i.  Demonstrate that a significant number of individuals eligible for
    RESEP reside within the proposed service area.

j.  Document a lack of available health care services for persons with
    possible radiogenic cancers and other radiogenic diseases within the
    proposed service area.

**B. RESOURCES/CAPABILITIES (10 points maximum):**

> **1. Description of the Organization**

a.  Provide a history of the organization in regard to its experience in
    serving individuals with radiogenic cancers, as well as the
    organization's mission statement and the date the organization was
    founded.

b.  Describe the organizational structure and the philosophy behind the
    design of the organizational structure (including sponsorship or
    corporate affiliation, if appropriate).

c.  Identify unique characteristics and significant accomplishments of
    the organization.

**2. Staffing**

> Describe the proposed staffing and facility. Discuss comprehensiveness
> and continuity of care, including:

-   How services will be provided -- via staff providers, contract
    and/or through referral.

-   Other professional staff could include: registered nurses, patient
    education specialists, case managers, patient care coordinators and
    outreach coordinators.

-   Staff composition -- There must be a licensed physician, physician
    assistant, or nurse practitioner on staff.

> Applicants must present a staffing plan and provide justification for
> the plan. The plan should include 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 program staff must be
> included in your Attachment 3. Copies of biographical sketches for any
> key employed personnel that will be assigned to work on the proposed
> program must be included in your Attachment 4.

**C. RESPONSE (60 points maximum)**

> **1. Program Plan**

a.  Describe the organization's approach to meeting the service area and
    user needs.

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1)  Explain how the organization fits into the service area and its
    service delivery network.

2)  Describe the roles of patients, community, staff, in establishing
    and developing the proposed program.

3)  Attach in your Attachment 5 evidence of the community's support for
    the organization and the proposed new program (e.g., contracts,
    letters of agreement, Memoranda of Understanding etc.).

```{=html}
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```
b.  Describe the proposed service delivery model and the services to be
    provided.

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```
1)  Provide a summary of the proposed service delivery model (e.g.,
    mobile, fixed, freestanding, and hospital-based or combination).

2)  Describe how the proposed model is responsive to community needs
    (i.e., the applicant provides a service delivery plan that address
    the priority health and social problems for all the life cycles of
    the target population).

3)  Discuss the extent to which program activities are coordinated and
    integrated with the activities of other Federally-funded, state and
    local health services delivery programs and programs serving the
    same population. Describe both formal and informal arrangements.

4)  Describe how the proposed program is a cost-effective approach to
    meeting the health care needs of the target population given the
    level of health care resources currently available in the service
    area.

5)  Discuss how the proposed model will assure that all persons will
    have ready access to the required health services either directly
    on-site or through established arrangements.

6)  Adequately describe the program in place or proposed for the
    delivery of required services.

7)  Demonstrate that the proposed service delivery model is appropriate
    and responsive to the identified unmet needs of the target
    population.

8)  Delineate appropriate core services that **must** include: outreach,
    education, screening and early detection, referrals for medical
    treatment, RECA eligibility assistance, quality assurance, data
    collection, finance, and performance reports are appropriately and
    persuasively described.

9)  Describe arrangements for unduplicated services at a specific
    geographic area where a significant number of eligible individuals
    are located.

10) Discuss how applicant is equipped to provide services at multiple
    locations (that serve widely dispersed populations) to ensure that
    all eligible individuals throughout the service area have access to
    services.

## 2. Organizational Capabilities and Expertise

1.  Describe why the applicant organization is the appropriate entity to
    establish this program (e.g., staff skills, capacity, and clinical
    outcomes).

2.  Describe the organization's prior experience in working with the
    target population; in addressing the identified problem; and
    developing and implementing appropriate clinical systems.

3.  Describe the management team structure and process for hiring key
    management staff.

4.  Describe the proposed or existing accounting and internal control
    systems. Demonstrate how they are in accord with sound financial
    management procedures and are appropriate to the size of the
    organization, funding requirements, and staff skills available.

5.  Describe the proposed processes, mechanisms and data systems to
    track individuals from initial contact and screening through final
    diagnosis and participation in the RECA compensation program.

6.  Successful applicants demonstrate the existence of formal written
    plans for collaborative arrangements with media, educators,
    oncologists, cancer centers, radiologists, hospitals, rehabilitation
    services, legal services and benefits counselors that are available
    and accessible to users (a copy of all formal arrangements must be
    included). If these types of collaborative arrangements do not
    exist, applicant demonstrates that these activities are handled
    within the program (e.g., rehabilitation services, patient
    education; oncological services; legal services; and benefits
    counseling).

7.  Demonstrate appropriate collaborations and partnerships in the
    service area (including other Federally-funded organizations) to
    assure a seamless continuum of education and health care service
    delivery and access to appropriate specialty care for the target
    population (e.g., signed Memorandum of Understanding, contracts,
    referral agreements).

## 3. Readiness

> Describe the state of readiness and the program's current assets that
> will support development of RESEP services. Specifically, successful
> applicants demonstrate:

-   Existing and/or potential facility space that will be modified to
    accommodate the RESEP.

-   That, within 90 days of the award of the grant, a facility will be
    available, ready for occupancy and adequate to serve the proposed
    population/service area and providers will be available to serve at
    this facility.

-   Existing or potential matching funds and the time allowance to
    allocate the funds (helpful, but not required).

-   Personnel currently identified to staff the RESEP program.

-   Existing infrastructure in terms of equipment and/or supplies.

-   Existing resources in the community that RESEP can rely upon to
    develop and sustain the program.

-   Capacity to serve affected populations in the high impact states of
    Arizona, Colorado, Idaho, Nevada, New Mexico, North Dakota, Oregon,
    South Dakota, Texas, Utah, Washington, Wyoming.

-   Evidence of current operation of a clinic for patients with
    Radiogenic cancers and occupationally related diseases.

-   Capability and commitment of the current Board, administration and
    management to develop and sustain the RESEP.

-   That it has arrangements with other providers in the service area
    for accepting referrals.

-   That the facility is fully described in terms of staffing, number of
    exam rooms, and services to be provided.

-   At a minimum, that within 90-days of a grant award: (1)
    staff/provider(s) will be recruited and hired; (2) the facility will
    be available (e.g., provide lease agreements, floor plans in your
    Attachment 5); and (3) services will be available to the target
    population. The ORHP will consider a waiver for a longer start up
    period on a case-by-case basis for good cause.

-   Inclusion in your Attachment 5, agreement from site sponsor to allow
    applicant organization to provide services at specified location.

-   The facility\'s condition, size, space, and location are suitable
    for the purposes of the RESEP. Applicant fully describes the program
    in place or proposed for the delivery of required services.

-   A proposed health care delivery system that includes appropriate
    core services, that **must** include outreach, education, screening
    and early detection, referrals for medical treatment, RECA
    eligibility assistance, quality assurance, data collection, finance,
    performance reports.

-   That there will be adequate equipment for screening and diagnosis,
    and an appropriate system for patient follow-up.

-   Appropriate and persuasive plans for public education on the risk of
    radiogenic disease based on specific exposures.

##  4. Input from Program Users

> Describe the mechanism for receiving input from program users about
> what and how services are provided. Discuss the organization's plan
> for assuring that input is received from the service area/target
> population to be served. Input should be focused on such areas as
> services to be provided, program policies and patient satisfaction.

##  5. Health Care Plan

> In general, this section should be used to outline specific,
> measurable, time-limited objectives and action plans related to
> identified health needs/issues and quality improvement activities
> within the practice that are specific to the new program for which
> Federal funding is being requested. Fiscal, administrative, MIS and
> leadership activities are, in general, described in the Business Plan.
> However, clinically related MIS, administrative or management issues
> may also be described in the Health Care Plan.

##  6. Business Plan

> A sample format is provided in Section XIII. Applicants should use
> this section to outline goals and objectives specific to the program
> for which Federal funding is requested. The Business Plan should also
> indicate how the goals and objectives are tied into the overall
> operational business goals of the organization.
>
> The Business Plan should be formatted in the categories of
> Administrative, Governance, Fiscal, and MIS. Applicants are expected
> to address the following issues in the Business Plan:

-   Activities specific to the RESEP;

-   Continuous quality improvement (fiscal, MIS, administrative); and

-   Plans for attaining and maintaining long-term viability (i.e.
    financial assets, future requirements for space, personnel).

> The Business Plan must also address in narrative form those issues
> that can not be captured in the table format, such as the following:

-   Audit conditions or exceptions identified in the most recent report.

-   Managed care arrangements and their impact on the organization.

-   Factors that may have affected, or are expected to affect, progress
    for the new program in either a positive or negative way.

-   Partnerships, contractual arrangements, and financial/legal
    arrangements with other entities.

**D. SUPPORT REQUESTED (10 points maximum)**

> Successful applicants:

-   Provide a proposed budget that is appropriate for the scope of the
    proposed activities

-   Provide an annualized budget that is reasonable in terms of the (1)
    total cost per user/encounter, (2) Federal request versus total
    budget, (3) scope of the services proposed.

-   Demonstrate projected patient income that is reasonable based on the
    patient mix and the number of projected users and encounters.

-   Present Business Plan goals and objectives that demonstrate
    appropriate financial planning in the development of the proposal
    and for the long-term success of the program.

-   Clearly delineate other sources of funding on the SF 424 and
    explains their source in the budget narrative.

-   Demonstrate that Federal funds are being used to leverage other
    sources of funding and that alternative sources of revenue are being
    maximized to support the proposed program. It is extremely important
    that applicant aggressively pursues third party billing and
    collection.

**E. EVALUATIVE MEASURES (5 points maximum)**

-   Describe the plan for how the success of the RESEP will be
    evaluated. A successful plan will specify how the applicant will
    assess whether stated objectives were met through program
    activities.

-   Discuss a performance improvement system that includes reducing
    patient risk, improving patient satisfaction, credentialing and
    privileging and incident reporting that integrates planning,
    management, leadership and governance into the evaluation processes
    of program effectiveness.

-   Describe quality improvement mechanisms to assure culturally and
    linguistically appropriate services and a process to obtain patient
    feedback including conducting patient satisfaction surveys.

-   Describe a case management system that demonstrates care
    coordination at all levels of health care including a description of
    clinical staffing pattern (e.g., number and mix of providers and
    clinical support staff) and a description of the mechanism to be
    used for the recruitment and retention plan for achieving the
    proposed staffing pattern.

**F. IMPACT (5 points maximum)**

-   Describe what impact there will be on the health of the user
    population and how problem areas or unmet objectives will be
    remedied after they are identified.

    []{#__RefHeading___Toc183319101 .anchor}**[2. Review and Selection
    Process]{.smallcaps}**

> 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.

[]{#__RefHeading___Toc183319102 .anchor}**[3. Anticipated Announcement
and Award Dates]{.smallcaps}**

> It is expected that the Notice of Grant Award (NGA) will be sent
> electronically to successful applicants, from Grants Management, in
> September 2008. Applicants, whether successful or not, should receive
> written notification of the funding decision from the Office of Rural
> Health Policy, by September 1, 2008.

[]{#__RefHeading___Toc183319103 .anchor}**VI. Award Administration
Information**

[]{#Award_PostAwardNotice .anchor}

**[1. Award Notices]{.smallcaps}**

> 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, 2008.

[]{#__RefHeading___Toc183319105 .anchor}**[2. Administrative and
National Policy Requirements]{.smallcaps}**

> Successful applicants must comply with the administrative requirements
> outlined in 45 CFR Part 74 (non-governmental) or 45 CFR Part 92
> (governmental), as appropriate.
>
> HRSA grant awards are subject to the requirements of the HHS Grants
> Policy Statement (HHS GPS) that are applicable to the grant based on
> recipient type and 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**

[]{.mark}

**[HEALTHY PEOPLE 2010]{.smallcaps}**

> **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}/.

[]{.mark}

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

[]{#Award_OtherReportingRequirements .anchor}

**[3. Reporting]{.smallcaps}**

> 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
> [www.whitehouse.gov/omb/circulars](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 budget period. The report
> is an accounting of expenditures under the project that year. More
> specific information will be included in the award notice;
>
> 2\. Submit a **Progress Report**(s). Further information will be
> provided in the award notice.
>
> 3\. Submit other reports as noted on your Notice of Grant Award
>
> d\. **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 to participate, where
> appropriate, in an on-site performance review of their HRSA funded
> program(s) by a review team from one of the ten OPR regional
> divisions. Grantees should expect to participate in a performance
> review at some point during their project period. 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 that identifies key actions to
> improve program performance as well as addresses any identified
> program requirement issues. 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>.
>
> []{.mark}

[]{#__RefHeading___Toc183319107 .anchor}**VII. Agency Contacts**

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

Ms. Valerie Barton

Grants Management Specialist

HRSA Division of Grants Management Operations, OFAM

Parklawn Building, Room 11A-02

5600 Fishers Lane

Rockville, MD 20857

Telephone: 301-443-4580

Fax: 301-443-6686

Email: vbarton@hrsa.gov

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

Vanessa Hooker

Project Officer, Office of Rural Health Policy

Attn: RESEP

HRSA

Parklawn Building, Room 9A-55

5600 Fishers Lane

Rockville, MD 20857

Telephone: 301-594-5105

Fax: 301-443-2803

Email: vhooker@hrsa.gov

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

Vanessa Hooker

Project Officer, Office of Rural Health Policy

Attn: RESEP

HRSA

Parklawn Building, Room 9A-55

5600 Fishers Lane

Rockville, MD 20857

Telephone: 301-594-5105

Fax: 301-443-2803

Email: vhooker@hrsa.gov

[]{#__RefHeading___Toc183319108 .anchor}**VIII. Other Information**

**[HELPFUL WEBSITES]{.smallcaps}:**

Additional information about RESEP is available on HRSA's Office of
Rural Health Policy website at
<http://ruralhealth.hrsa.gov/funding/RESEP/index.htm>

Information on the HRSA's Office of Rural Health Policy Programs and
information on technical assistance may be found at
[www.orhp.hrsa.gov](http://www.orhp.hrsa.gov/) or 301-442-0835.

ORHP funds a State Office of Rural Health (SORH) in every state. The
mission of the State Offices is to help their individual rural
communities build health care delivery systems. The list of State
Offices of Rural Health may be found at
<http://ruralhealth.hrsa.gov/funding/50sorh.htm>.

The Rural Assistance Center (RAC) offers grantees access to many
services including information on available programs, funding and
research available to provide quality rural health services to rural
residents. You may contact the RAC at
[www.raconline.org](http://www.raconline.org/), or by calling
1-800-270-1898. You may also send an e-mail to: <info@raconline.org> or
send us a fax at 1-800-270-1913.

Information on the Department of Justice Radiation Exposure Compensation
Program may be found at <http://www.usdoj.gov/civil/torts/const/reca/>
or 1-800-729-7327.

Information on the Department of Labor Energy Employees Occupational
Illness Compensation Program may be found at:

[[http://www.usdoj.gov/civil/torts/const/reca/eeoicpa.htm]{.underline}](http://www.usdoj.gov/civil/torts/const/reca/eeoicpa.htm)
or at <http://www.dol.gov/dol/esa/regs/compliance/owcp/eeoicp/main.htm>

**IX. 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, service area, barriers to
health care, or health care needs in your community. 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. Avoid the risk of
having reviewers hunt through your application for information.

**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. Your budget should
reflect back to the proposed activities, and all forms should be filled
in accurately and completely.

**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 to the appropriate text in
the application. Be sure to upload the attachments in the order
indicated in the forms.

**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.**

**x. Definitions, Eligibility, and Screening Requirements for
Compensation under the Radiation Exposure Compensation Act**

**Uranium miners**

The individual must have been employed in an aboveground or underground
uranium mine located in Colorado, New Mexico, Arizona, Wyoming, South
Dakota, Washington, Utah, Idaho, North Dakota, Oregon, and Texas at any
time during the period beginning on January 1, 1942, and ending on
December 31, 1971.

The individual must have been exposed to 40 or more working level months
of radiation or worked for at least one year while employed in uranium
mine during the time period referenced above.

Additional mining States may be included if: an Atomic Energy Commission
uranium mine was operated in such State at any time during the period
beginning on January 1, 1942, and ending on December 31, 1971; the State
submits an application to the Department of Justice to include such
State; and the Attorney General makes a determination to include such
State.

The term uranium mine means any underground excavation, including "dog
holes," as well as open pit, strip, rim, surface, or other aboveground
mines, where uranium ore or vanadium-uranium ore was mined or otherwise
extracted.

Employment in a uranium mine includes, but is not limited to: miner,
miner\'s helper (nipper), production driller, long hole driller, tram
operator (trammer, or motorman), equipment operator (mucker), slusher
operator (slusherman), laborer (bull gang), powderman, timberman,
hoistman, skip tender, underground truck driver (trucker), shift foreman
(boss, shifter, or leadman), mechanic, electrician, geologist, surveyor,
surveyor\'s helper (rodman), grade controller (prober), air sampler,
safety engineer, and mine superintendent (super). Non-company personnel
performing the following activities/occupations include, but are not
limited to; mine inspectors, health physicists, and Atomic Energy
Commission (AEC) geologists and engineers.

Screening and early detection will be provided for the following
diseases: primary lung cancer and certain nonmalignant respiratory
diseases including pulmonary fibrosis, Cor pulmonale resulting from
fibrosis, silicosis, and or pneumoconiosis.

**Uranium millers**

The individual must have been employed in a uranium mill located in
Colorado, New Mexico, Arizona, Wyoming, South Dakota, Washington, Utah,
Idaho, North Dakota, Oregon, and Texas at any time during the period
beginning on January 1, 1942, and ending on December 31, 1971.

The individual must have worked for at least one year during the time
period referenced above.

The term uranium mill includes milling operations involving the
processing of uranium ore or vanadium-uranium ore, including both
carbonate and acid leach plants.

Screening and early detection will be provided for the following
diseases: primary lung cancer, certain nonmalignant respiratory diseases
(including pulmonary fibrosis, Cor pulmonale resulting from fibrosis,
silicosis, and pneumoconiosis), renal cancer, and other chronic renal
diseases including nephritis and kidney tubal tissue injury.

**Ore transporters**

The individual must have been employed in the transport of uranium ore
or vanadium-uranium ore from mines or mills located in Colorado, New
Mexico, Arizona, Wyoming, South Dakota, Washington, Utah, Idaho, North
Dakota, Oregon, and Texas at any time during the period beginning on
January 1, 1942, and ending on December 31, 1971.

The individual must have worked for at least one year during the time
period referenced above.

Screening and early detection will be provided for the following
diseases: primary lung cancer, certain nonmalignant respiratory
diseases, renal cancer, and other chronic renal diseases including
nephritis and kidney tubal tissue injury.

**Downwinders**

The individual must have been physically present in one of the affected
areas downwind of the Nevada Test Site during a period of atmospheric
nuclear testing. The individual must have lived or worked downwind of
atmospheric nuclear tests in certain counties in Utah, Nevada and
Arizona for a period of at least two years during the period beginning
on January 21, 1951, and ending on October 31, 1958, or, for the period
beginning on June 30, 1962, and ending on July 31, 1962.

The designated affected areas for the Nevada Test Site are: in the State
of Utah, the counties of Beaver, Garfield, Iron, Kane, Millard, Piute,
San Juan, Sevier, Washington, and Wayne; in the State of Nevada, the
counties of Eureka, Lander, Lincoln, Nye, White Pine, and that portion
of Clark County that consists of townships 13 through 16 at ranges 63
through 71; and in the State of Arizona, the counties of Apache,
Coconino, Gila, a portion of Mohave County (located north of the Grand
Canyon), Navajo, and Yavapai.

Screening and early detection will be provided for the following
cancers: leukemia (other than chronic lymphocytic leukemia), primary
lung cancer, multiple myeloma, lymphomas (other than Hodgkin's disease),
and primary cancer of the thyroid, male or female breast, esophagus,
stomach, pharynx, small intestine, pancreas, bile ducts, gall bladder,
salivary gland, urinary bladder, brain, colon, ovary, or liver.

**On-site participants**

The individual must have participated onsite in a test involving the
atmospheric detonation of a nuclear device. The individual must have
been present "on-site" above or within the official boundaries of the
Nevada, Pacific, Trinity, or South Atlantic Test Sites at any time
during a period of atmospheric nuclear testing and must have
"participated" during that time in the atmospheric detonation of a
nuclear device. (While on-site participants at the Pacific and South
Atlantic test sites are eligible for RECA compensation, organizations
located in these areas are not eligible to apply for RESEP grant funds.)

On-site means physical presence above or within the official boundaries
of any of the following locations:

-   The Nevada Test Site, Nevada -- in the State of Utah, the counties
    of Beaver, Garfield, Iron, Kane, Millard, Piute, San Juan, Sevier,
    Washington, and Wayne; in the State of Nevada, the counties of
    Eureka, Lander, Lincoln, Nye, White Pine, and that portion of Clark
    County that consists of townships 13 through 16 at ranges 63 through
    71; and in the State of Arizona, the counties of Apache, Coconino,
    Gila, a portion of Mohave County (located north of the Grand
    Canyon), Navajo, and Yavapai .

-   The Pacific Test Sites - Bikini Atoll, Enewetak Atoll, Johnston
    Island, Christmas Island, the test site for the shot during
    Operation Wigwam, the test site for Shot Yucca during Operation
    Hardtack I, and the test sites for Shot Frigate Bird and Shot
    Swordfish during Operation Dominic I) and the official zone around
    each site from which non-test affiliated ships were excluded for
    security and safety purposes.

-   The Trinity Test Site, New Mexico.

-   The South Atlantic Test site for Operation Argus and the official
    zone around the site from which non-test affiliated ships were
    excluded for security and safety purposes.

-   Any designated location within a Naval Shipyard, Air Force Base, or
    other official government installation where ships, aircraft or
    other equipment used in an atmospheric nuclear detonation were
    decontaminated.

-   Any designated location used for the purpose of monitoring fallout
    from an atmospheric nuclear test conducted at the Nevada Test Site.

**Eligibility/Screening:**

Participant means:

1)  An individual who was:

    i.  A member of the armed forces;

    ii. A civilian employee or contractor employee of the Manhattan
        Engineer District, the Armed Forces Special Weapons Project, the
        Defense Atomic Support Agency, the Defense Nuclear Agency, the
        Department of Defense or its components or agencies or
        predecessor components or agencies;

    iii. An employee or contractor employee of the Atomic Energy
         Commission, the Energy Research and Development Administration
         or Department of Energy;

    iv. A member of the Federal Civil Defense Administration or the
        Office of Civil and Defense Mobilization; or

    v.  A member of the U.S. Public Health Service; and

2\) Who:

i.  Performed duties within the identified operational area around each
    atmospheric nuclear test;

ii. Participated in the decontamination of any ships, planes, or
    equipment used during the atmospheric nuclear test;

iii. Performed duties as a cloud tracker or cloud sampler;

iv. Served as a member of the garrison or maintenance forces on the
    atoll of Enewetak during June 21, 1951 through July 1, 1952; August
    7, 1956 through August 7, 1957; or November 1, 1958 through April
    30, 1959; or

v.  Performed duties as a member of a mobile radiological safety team
    monitoring the pattern of fallout from an atmospheric nuclear test.
    ^\*^

> Atmospheric detonation of a nuclear device means only those tests
> conducted by the United States prior to January 1, 1963. The complete
> list of atmospheric nuclear tests, event names, dates and locations
> can be found in the 28 CFR Part 79 Vol. 67, No. 152, pp. 51431-51433.
> .

**XI. RESEP Annual Data Reporting**

**Sample Annual Report**

**Program Identification**

Name of Grantee:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Reporting Period:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+---------------------------------------+------------+----------------+
| **Program Activity by Type of         |            |                |
| Activity**                            |            |                |
+---------------------------------------+------------+----------------+
| Activity                              | Number     |                |
+---------------------------------------+------------+----------------+
| Screening                             |            |                |
+---------------------------------------+------------+----------------+
| Screening Follow-up Calls             |            |                |
+---------------------------------------+------------+----------------+
| Medical Referrals                     |            |                |
+---------------------------------------+------------+----------------+
| Follow-Up                             |            |                |
+---------------------------------------+------------+----------------+
| Diagnosis                             |            |                |
+---------------------------------------+------------+----------------+
| Treatment                             |            |                |
+---------------------------------------+------------+----------------+
| Mental Health/Depression Screening    |            |                |
+---------------------------------------+------------+----------------+
| Referrals                             |            |                |
+---------------------------------------+------------+----------------+
| RECA Eligibility Assistance           |            |                |
+---------------------------------------+------------+----------------+
| **OUTREACH/EDUCATION ENCOUNTERS**     | **SESSIO   | **INDIVIDUAL** |
|                                       | NS/ITEMS** |                |
+---------------------------------------+------------+----------------+
| Face-to Face                          |            |                |
+---------------------------------------+------------+----------------+
| Telephone Encounters (general)        |            |                |
+---------------------------------------+------------+----------------+
| Telephone Encounters (Screening       |            |                |
| follow-up calls)                      |            |                |
+---------------------------------------+------------+----------------+
| Presentations (e.g. Community         |            |                |
| meetings, forums, events, health      |            |                |
|                                       |            |                |
| fairs, education classes)             |            |                |
+---------------------------------------+------------+----------------+
| Pamphlets/ brochures distributed      |            |                |
+---------------------------------------+------------+----------------+
| Other                                 |            |                |
+---------------------------------------+------------+----------------+
| **MEDIA**                             | **NUMBER** | **EXPECTED     |
|                                       |            | AUDIENCE**     |
+---------------------------------------+------------+----------------+
| Radio                                 |            |                |
+---------------------------------------+------------+----------------+
| TV spots                              |            |                |
+---------------------------------------+------------+----------------+
| Letters                               |            |                |
+---------------------------------------+------------+----------------+
| Newspaper Articles/Ads                |            |                |
+---------------------------------------+------------+----------------+
| Other                                 |            |                |
+---------------------------------------+------------+----------------+

> \*List each major non-medical encounter and the number for each.

+-------------------+------+-------+--------+--------+-------+------+
| Number of         |      |       |        |        |       |      |
| individuals       |      |       |        |        |       |      |
| screened          |      |       |        |        |       |      |
| according to the  |      |       |        |        |       |      |
| source of         |      |       |        |        |       |      |
| radiation         |      |       |        |        |       |      |
| exposure and      |      |       |        |        |       |      |
| disease type      |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| Diagnosis         | So   |       |        |        |       |      |
|                   | urce |       |        |        |       |      |
|                   | of   |       |        |        |       |      |
|                   | Expo |       |        |        |       |      |
|                   | sure |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
|                   | Ura  | Ur    | Ore    | Down   | O     | Mult |
|                   | nium | anium |        | winder | nsite | iple |
|                   | Mi   | Mi    | Transp |        |       | Sou  |
|                   | ners | llers | orters |        | P     | rces |
|                   |      |       |        |        | artic |      |
|                   |      |       |        |        | ipant |      |
+-------------------+------+-------+--------+--------+-------+------+
| Malignant Disease |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| Non- Malignant    |      |       |        |        |       |      |
| Disease           |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| Other (Specify)   |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > TOTAL           |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+

  --------------------- ---------------- ------------------ ------------------
  NUMBER OF SCREENING                                       
  AND DIAGNOSTIC TESTS                                      
  OFFERED ACCORDING TO                                      
  DELIVERY METHOD                                           

  Screening and Testing DELIVERY METHOD                     

                        Provided by      By                 By
                        Grantee          Referral/Grantee   Referral/Grantee
                                         Pays               Doesn't Pay

  Medical History                                           

  Occupational History                                      

  Environmental                                             
  Exposure                                                  

  Physical Examination                                      

  Focused Physical                                          
  Examination                                               

  Pulse Oximetry                                            

  Spirometry                                                

  Chest X-ray                                               

  Arterial Blood Gas                                        

  Electrocardiogram                                         
  (EKG)                                                     

  Chest CT                                                  

  Urinalysis (UA)                                           

  Hemocult                                                  

  Basic Metabolic Panel                                     

  Complete Blood Count                                      
  (CBC)                                                     

  (BUN)                                                     

  Creatinine                                                

  PSA (men)                                                 

  Mammogram (women)                                         

  Colonoscopy                                               

  PAP Smear (women)                                         

  Thyroid Stimulating                                       
  Hormone-TSH                                               

  Other (Specify)                                           

                                                            

                                                            

                                                            

                                                            

                                                            

                                                            

                                                            

                                                            

                                                            

                                                            

  TOTAL                                                     
  --------------------- ---------------- ------------------ ------------------

+-------------------+------+-------+--------+--------+-------+------+
| Number of         |      |       |        |        |       |      |
| individuals       |      |       |        |        |       |      |
| diagnosed         |      |       |        |        |       |      |
| according to the  |      |       |        |        |       |      |
| source of         |      |       |        |        |       |      |
| radiation         |      |       |        |        |       |      |
| exposure and      |      |       |        |        |       |      |
| disease           |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| Diagnosis         | So   |       |        |        |       |      |
|                   | urce |       |        |        |       |      |
|                   | of   |       |        |        |       |      |
|                   | Expo |       |        |        |       |      |
|                   | sure |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
|                   | Ura  | Ur    | Ore    | Down   | O     | Mult |
|                   | nium | anium |        | winder | nsite | iple |
|                   | Mi   | Mi    | Transp |        |       | Sou  |
|                   | ners | llers | orters |        | P     | rces |
|                   |      |       |        |        | artic |      |
|                   |      |       |        |        | ipant |      |
+-------------------+------+-------+--------+--------+-------+------+
| Malignant         |      |       |        |        |       |      |
| Diseases          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Multiple        |      |       |        |        |       |      |
| > Myeloma         |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Lymphomas       |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Leukemia        |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Lung Cancer     |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Renal Cancer    |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Thyroid Cancer  |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Breast Cancer   |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Esophagus       |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Stomach Cancer  |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Pharynx Cancer  |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Intestinal      |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Pancreatic      |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Bile Duct       |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Gall Bladder    |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Salivary Gland  |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Urinary Bladder |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Brain Cancer    |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Colon Cancer    |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Ovarian Cancer  |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Liver Cancer    |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Testicular      |      |       |        |        |       |      |
| > Cancer          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Prostate Cancer |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Other Cancers   |      |       |        |        |       |      |
| > (Specify)       |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
|                   |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| Non-Malignant     |      |       |        |        |       |      |
| Diseases          |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Respiratory     |      |       |        |        |       |      |
| > Diseases        |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Chronic Renal   |      |       |        |        |       |      |
| > Disease         |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
| > Other (Specify) |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+
|                   |      |       |        |        |       |      |
+-------------------+------+-------+--------+--------+-------+------+

NOTE: Include only those individuals screened during this reporting
period

+------------------+-------+------+--------+--------+-------+------+
| Number of        |       |      |        |        |       |      |
| program users    |       |      |        |        |       |      |
| according to the |       |      |        |        |       |      |
| source of        |       |      |        |        |       |      |
| radiation        |       |      |        |        |       |      |
| exposure and     |       |      |        |        |       |      |
| extent of        |       |      |        |        |       |      |
| participation in |       |      |        |        |       |      |
| RECA             |       |      |        |        |       |      |
+------------------+-------+------+--------+--------+-------+------+
|                  | S     |      |        |        |       |      |
|                  | ource |      |        |        |       |      |
|                  | of    |      |        |        |       |      |
|                  | Exp   |      |        |        |       |      |
|                  | osure |      |        |        |       |      |
+------------------+-------+------+--------+--------+-------+------+
|                  | Ur    | Ura  | Ore    | Down   | O     | Mult |
|                  | anium | nium |        | winder | nsite | iple |
|                  | M     | Mil  | Transp |        |       | Sou  |
|                  | iners | lers | orters |        | P     | rces |
|                  |       |      |        |        | artic |      |
|                  |       |      |        |        | ipant |      |
+------------------+-------+------+--------+--------+-------+------+
| Presumed RECA    |       |      |        |        |       |      |
| eligible         |       |      |        |        |       |      |
+------------------+-------+------+--------+--------+-------+------+
| Submitted RECA   |       |      |        |        |       |      |
| application      |       |      |        |        |       |      |
+------------------+-------+------+--------+--------+-------+------+
| Received RECA    |       |      |        |        |       |      |
| Compensation     |       |      |        |        |       |      |
+------------------+-------+------+--------+--------+-------+------+

NOTE: Please attach a brief narrative description of any significant
events, issues, accomplishments or challenges.

**XII.** **Definition of Terms for RESEP Data Reporting**

Reporting Period: The reporting period is the most recent 12-month
budget period. For the Annual Report due October 1, 2008, the reporting
period is September 1, 2007 -- August 31, 2008. The data presented in
the report should reflect all RESEP grant activity during this period.
The data should not be cumulative for the entire RESEP program.

Medical User: An individual officially enrolled in the radiation
exposure screening and education program (RESEP) AND who has had at
least one medical encounter (e.g., screening) during the reporting year.
A medical user is not equivalent to an encounter. A medical user that
has had multiple encounters with the RESEP program should be counted
only once.

Medical Encounter: Encounters are defined to include a documented,
face-to-face contact between a medical user and a health care provider
{physician, physician assistant, registered nurse, and nurse
practitioner} who exercises independent judgment in the provision of
RESEP health services to the individual.

Health Care Provider: A health care provider is the individual who
assumes primary responsibility for assessing the patient's health status
and documenting health services provided in the patient\'s record.
Providers include only individuals who exercise independent judgment as
to the health services rendered to the patient during a medical
encounter. The health care provider who exercises independent judgment
is credited with the encounter, even when two or more health care
providers are present and participate.

Non-medical encounter: Encounter between an individual and non health
care provider for the purpose of providing non-medical services such as
outreach activities, education or benefits counseling. Please note that
individuals who are the recipient for outreach services may or may not
be officially enrolled in the RESEP; that is, these individuals may or
may not be medical users.

Screening: means that the individual has been registered for the RESEP,
has a documented medical encounter with a health care provider AND
receives a history and physical examination as mandated by legislation.

Outreach or Telephone Contacts: Number of individuals with whom the
RESEP program has had face-to-face contact. Contact may occur
individually or in a group. The purpose of outreach contacts is case
finding or to identify potential clients and/or facilitate
access/referral of clients to available RESEP services. Members of the
intended audience for TV announcements, radio announcements, direct
mailings, or printed material should not be counted as outreach
contacts.

Educational Activities: Activities designed to promote knowledge and
inform individuals about radiation exposure, potential for disease
related to radiation exposure, and preventive health care practices.
Public information activities (e.g., TV ads, radio spots, PSAs,
brochures/pamphlets) designed to inform the public about RESEP and/or
RECA should also be counted as educational activities.

RECA Eligibility Assistance: Assistance provided to individuals or
groups of individuals about the RECA program, including information
about eligibility, required documentation (e.g., medical, residency, and
work history), application instructions, filing and approval processes,
possible compensation, and referral for legal services.

**XIII.** **Guidelines for Developing Health Care and Business Plans**

The following components are intended for use in both the Health Care
and Business Plans. Presenting the plans in \"landscape\" print format
may facilitate easier reading and usage.

Problem/Need Statements are clearly and specifically defined
descriptions of major needs or problems, quantified where possible. The
problem/need statements should tie into and flow from the overall
program description. For example, such statements in the Health Care
Plan may address:

1.  Needs of the overall health system, covering multiple programs and
    populations.

2.  Identification of disparities in health outcomes among populations
    served.

3.  Problems of a specific program or services.

4.  Needs of a specified population.

Column 1: Goals and Objectives. Goals are relatively broad and express a
sense of a desired future state or direction. Goals should address
identified needs or problems and are usually long-term. Objectives are
descriptions of desired, measurable, time‑limited results or outcomes.
These objectives (intended results or outcomes) are measures of progress
towards a goal. They can be used to identify an acceptable level of
performance or establish criteria for evaluation. Objectives can be
either short‑term (less than 1 year) or long‑term (1 year or longer).
Use an upper case letter (A\...) for each goal and list corresponding
objectives by number (1\...).

Column 2: Key Action Steps - the major activities that must occur to
accomplish an objective - critical actions that must be taken to attain
the measurable outcome or end result. Reference each action step by
corresponding upper case letter for goal, number for objective, and
lower case letter for action step (i.e., A.1.a.).

Column 3: Data Source and Evaluation Method - the source of data and
method used to evaluate progress towards an objective or to identify the
actual outcome distinguished in the objective. Reference each action
step in the same manner as above for Key Action Steps.

Column 4: Outcome - action steps to be taken towards an objective;
quantifiable documented outcomes to be achieved. This column must be
completed for each objective shown in previous plans. Reference each
action step in the same manner as above for Key Action Steps.

Column 5: Comments - supplementary information for related entries in
the plan. Reference each action step in the same manner as above for Key
Action Steps.

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  -----------------------------------------------------------------------

**Sample Health Care & Business Plan Presentation**

This sample Health Care and Business Plan presentation is provided as a
broad outline. Additional information may be provided to fully describe
your proposal:

+---------+---------------+----------+-------------+--------+--------+
| Probl   |               |          |             |        |        |
| em/Need |               |          |             |        |        |
| Sta     |               |          |             |        |        |
| tement: |               |          |             |        |        |
+---------+---------------+----------+-------------+--------+--------+
| Go      | Key Action    | Data     | Outcome and | Perso  | Co     |
| als/Obj | Steps         | Source   | Measurement | n/Area | mments |
| ectives |               | and      |             | Respo  |        |
|         |               | Ev       |             | nsible |        |
|         |               | aluation |             |        |        |
|         |               | Method   |             |        |        |
+---------+---------------+----------+-------------+--------+--------+
| A. Goal | A.1.(a)       | A.1.(a)  | A.1(a)      | A      | A.1.   |
| (1)     | Action step 1 | Data &   | Outcome &   | .1.(a) | (a)    |
|         | for Objective | Ev       | Measurement | Perso  | C      |
| A.1.    | 1             | aluation |             | n/Area | omment |
| Ob      |               |          | A.1(b)      |        |        |
| jective | A.1 (b)       | A.1.(b)  | Outcome &   | A      | A.1.   |
| (1)     | Action step 2 | Data &   | Measurement | .1.(b) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
| A.2.    | 1             | aluation | A.2.(a)     | n/Area | mments |
| Ob      |               |          | Outcome &   |        |        |
| jective | A.2.(a)       | A.2.(a)  | Measurement | A      | A.2.   |
| (2)     | Action step 1 | Data &   |             | .2.(a) | (a)    |
|         | for Objective | Ev       | A.2.(b)     | Perso  | Co     |
|         | 2             | aluation | Outcome &   | n/Area | mments |
|         |               |          | Measurement |        |        |
|         | A.2 (b)       | A.2.(b)  |             | A      | A.2.   |
|         | Action step 2 | Data &   |             | .2.(b) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
|         | 2             | aluation |             | n/Area | mments |
+---------+---------------+----------+-------------+--------+--------+
| B. Goal | B.1.(a)       | B.1.(a)  | B.1.(a)     | B      | B.1.   |
| (2)     | Action step 1 | Data &   | Outcome &   | .1.(a) | (a)    |
|         | for Objective | Ev       | Measurement | Perso  | Co     |
| B.1.    | 1             | aluation |             | n/Area | mments |
| Ob      |               |          | B.1.(b)     |        |        |
| jective | B.1 (b)       | B.1.(b)  | Outcome &   | B      | B.1.   |
| (1)     | Action step 2 | Data &   | Measurement | .1.(b) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
| B.2.    | 1             | aluation | B.2.(a)     | n/Area | mments |
| Ob      |               |          | Outcome &   |        |        |
| jective | B.2.(a)       | B.2.(a)  | Measurement | B      | B.2.   |
| (2)     | Action step 1 | Data &   |             | .2.(a) | (a)    |
|         | for Objective | Ev       | B.2.(b)     | Perso  | Co     |
|         | 2             | aluation | Outcome &   | n/Area | mments |
|         |               |          | Measurement |        |        |
|         | B.2 (b)       | B.2.(b)  |             | B      | B.2.   |
|         | Action step 2 | Data &   |             | .2.(B) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
|         | 2             | aluation |             | n/Area | mments |
+---------+---------------+----------+-------------+--------+--------+
| C. Goal | C.1.(a)       | C.1.(a)  | C.1.(a)     | C      | C.1.   |
| (3)     | Action step 1 | Data &   | Outcome &   | .1.(a) | (a)    |
|         | for Objective | Ev       | Measurement | Perso  | Co     |
| C.1.    | 1             | aluation |             | n/Area | mments |
| Ob      |               |          | C.1.(b)     |        |        |
| jective | C.1 (b)       | C.1.(b)  | Outcome &   | C      | C.1.   |
| (1)     | Action step 2 | Data &   | Measurement | .1.(b) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
| C.2.    | 1             | aluation | C.2.(a)     | n/Area | mments |
| Ob      |               |          | Outcome &   |        |        |
| jective | C.2.(a)       | C.2.(a)  | Measurement | C      | C.2.   |
| (2)     | Action step 1 | Data &   |             | .2.(a) | (a)    |
|         | for Objective | Ev       | C.2.(b)     | Perso  | Co     |
|         | 2             | aluation | Outcome &   | n/Area | mments |
|         |               |          | Measurement |        |        |
|         | C.2 (b)       | C.2.(b)  |             | C      | C.2.   |
|         | Action step 2 | Data &   |             | .2.(b) | (b)    |
|         | for Objective | Ev       |             | Perso  | Co     |
|         | 2             | aluation |             | n/Area | mments |
+---------+---------------+----------+-------------+--------+--------+

**XIV. Sample Budget Narrative**

This sample budget narrative is provided as a broad outline. Additional
information may be provided to fully describe your proposal:

Expenses: [Year 1]{.underline} [Year 2]{.underline}

PERSONNEL: See Personnel by Position and ORHP Program \$ 80,000
\$100,000

FRINGE BENEFITS: Break out each portion of Fringe Benefits:

FICA \$ 20,000 \$ 25,000

> Retirement, etc.
>
> TOTAL: PERSONNEL & FRINGE \$100,000 \$125,000

TRAVEL

Providers CME (\$ per full-time equivalent (FTE)) \$ \$

Nursing CME (\$ per FTE) \$ \$

Other Professional CME (\$ per FTE) \$ \$

Travel to required meetings (\$ per attendees x \# of Trips) \$ \$

Executive Director (x meetings)

Other staff (x meetings)

Management & Board \$ \$

Other Board/Management Travel \$ \$

Local Travel (# of trips @ your mileage rate) \$ \$

> TOTAL: TRAVEL \$ 10,000 \$ 15,000

EQUIPMENT

5 exam tables @\$ 5,000 each \$25,000

> TOTAL: EQUIPMENT \$25,000 \$ 0

SUPPLIES

Office & Printing Supplies \$x.xx per encounter \$ \$

Medical Records \$.xx per encounter \$ \$

Medical Supplies \$x.xx per encounter \$ \$

Pharmacy Supplies including Drugs. Avg per \# of Prescriptions \$ \$

X-ray supplies Average per \# of X-rays \$ \$

Laboratory supplies per average \# of procedures \$ \$

Building and Maintenance Supplies per \# of sites \$ \$

> TOTAL: SUPPLIES \$ 3,000 \$ 4,000

CONTRACTUAL (Please describe with enough detail to justify the costs)

A Patient Care Contracts@

Outside Reference Lab

Smith Kline Beecham for any tests that cannot be performed \$ \$

in house (Avg \# of procedures @ Avg Cost)

Outside Contract Pharmacies (describe) \$ \$

(Avg \# of prescriptions X Avg Cost) \$

Specialist (name type) Contract with\_\_\_\_\_\_\_\_\_\_\_for (what
purpose) \$ \$

> \# of Patients served

Oncologist with\_\_\_\_\_\_\_\_\_\_\_(Avg \# of patients @ Avg Costs) \$
\$

Temporary Nursing Coverage (Avg \# of days @ Avg Costs) \$ \$

> Subtotal: Patient Care Contracts \$ \$

A Non-Patient Contracts@

Housekeeping Services with \_\_\_\_\_\_\_\_\_\_\_\_ for \# of sites \$
\$

Security Services with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ for \# of
hours per \$ \$

Computer Maintenance Contract \$ \$

> Subtotal: Non-Patient Contracts \$ \$
>
> TOTAL: CONTRACTUAL \$ 70,000 \$90,000

OTHER:

Payroll Processing Services \$ \$

Audit Services with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \$ \$

Legal Fees with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ fee per hour \$
\$

Association Dues \$ \$

Building Contents Insurance \$ \$

Telephone Service \$ \$

Answering Services \$ \$

Postage \$ \$

Utilities \$ \$

Rent (describe) \$ \$

Marketing/Outreach \$ \$

Any special taxes (describe) \$ \$

Technical Assistance

> TOTAL: OTHER \$ 35,000 \$ 37,000
>
> TOTAL: ALL BUDGET \$291,800 \$271,000

#### EQUIPMENT

4 exam tables (4 @ \$3,000) \$12,000 \$0

1 Medical X-Ray (1 @ \$17,800) \$17,800 \$0

8 Stools (8 @ \$250) \$ 2,000 \$0

20 Handpieces (20 @ \$600) \$12,000 \$0

1 Developing Unit (1 @ \$2,000) \$ 2,000 \$0

8 PCs and related software (8 @ \$3,500) \$28,000 \$0

### 

TOTAL ALL EQUIPMENT \$73,800 \$0

[]{#__RefHeading___Toc183319109 .anchor}APPENDIX A: HRSA's Electronic
Submission User Guide

# 1. Introduction

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

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

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

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

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

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

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

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

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

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

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

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

# 

# 2. Noncompeting Continuation Application

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

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

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)

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

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

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

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

-   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.

##  {#section-2 .unnumbered}

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

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

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

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

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

-   Authorizing Official (AO),

-   Business Official (BO), and

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

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

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

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

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

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

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

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

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

##  {#section-3 .unnumbered}

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

# 

# 3. Competing Application

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

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

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

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

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

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

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

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

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

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

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

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

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

-   Register the organization with Central Contractor Registry (CCR)

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

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

-   Register an Authorized Organization Representative (AOR)

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

-   Register the username and password with Grants.gov

-   Get authorized as an AOR by your organization

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

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

##  {#section-5 .unnumbered}

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

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

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

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

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

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

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

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

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

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

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

Please direct questions regarding PureEdge to Grants.gov. Contact the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
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 {#submit-application-2 .unnumbered}

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

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

Please direct questions regarding application submission to the
Grants.gov Contact Center at Tel.: 1-800-518-4726. Contact Center hours
of operation are Monday-Friday from 7:00 a.m. to 9:00 p.m. Eastern Time,
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 {#verify-status-of-application-2 .unnumbered}

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

In case of any errors, you must correct the application and resubmit it
to Grants.gov. If you are unable to resubmit because the opportunity has
since closed, **contact the Director of the Division of Grants Policy**
via email at <DGPWaivers@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".

# 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.

##  {#section-6 .unnumbered}

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

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

### 4.1.1 Font  {#font .unnumbered}

Please use an easily readable serif typeface, such as Times Roman,
Courier, or CG Times. The text and table portions of the application
must be submitted in not less than 12 point and 1.0 line spacing.
Applications not adhering to 12 point font requirements may be returned.
Do not use colored, oversized or folded materials. For charts, graphs,
footnotes, and budget tables, applicants may use a different pitch or
size font, not less than 10 pitch or size font. However, it is vital
that when scanned and/or reproduced, the charts are still clear and
readable.

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

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

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

### 4.1.3 Names {#names .unnumbered}

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

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

Please put all section headings flush left in bold type.

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

**Electronic Submissions**

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

Do not number the standard OMB approved form pages.

**Paper Submissions (When allowed)**

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

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

**Electronic Submissions**

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

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

##  {#section-7 .unnumbered}

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

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

HRSA uses two standard packages from Grants.gov.

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

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

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

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

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

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

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

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

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

# 

# 5. Customer Support Information

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

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

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

Please visit HRSA EHBs for online help. Go to:

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

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

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

# 

# 6. FAQs

## 6.1 Software {#software .unnumbered}

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

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

**System Requirements:**

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

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

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

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

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

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

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

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

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

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

Grants.gov website states:

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

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

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

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

IE 6.0 and above is the recommended browser.

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

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

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

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

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

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

##  {#section-10 .unnumbered}

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

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

**Competing Submissions:**

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

**Noncompeting Submissions:**

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

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

**Competing Submissions:**

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

**Noncompeting Submissions:**

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

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

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

**Competing Submissions:**

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

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

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

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.

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

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

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

**Competing Submissions:**

No. But you must **contact the Director of the Division of Grants
Policy** via email at <DGPWaivers@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.

##  {#section-11 .unnumbered}

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

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

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

##  {#section-12 .unnumbered}

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

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

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

[]{#__RefHeading___Toc183319167 .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 <DGPWaivers@hrsa.gov> 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
1-800-518-4726. 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.

**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. You must, however, ensure that a copy of the
SF-424/5161 Face Sheet is printed, signed, scanned, and included with
the electronic submission of your application as Attachment 1.

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 included in the electronic submission of the application.

**Performance Measures for Competitive Applications**

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

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

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