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

**Health Resources and Services Administration**

Healthcare Systems Bureau (HSB)

National Bioterrorism Hospital Preparedness Program (NBHPP)

***National Bioterrorism Hospital Preparedness Program (NBHPP)***

*New*

*Announcement Number HRSA 06-067*

**Catalog of Federal Domestic Assistance (CFDA) No. 93.889**

**PROGRAM GUIDANCE**

Fiscal Year 2006

**Application Due Date: *July 10, 2006***

**Release Date: *July 2, 2006***

**Date of Issuance*: July 2, 2006***

> *Melissa Sanders*
>
> *Branch Chief, National Bioterrorism Hospital Preparedness Program*
>
> *Telephone: 301-443-0924*

*Fax: 301-480-0334*

> *Authority: Section 319C-1 of the Public Health Service (PHS) Act*

**Guidance Table of Contents**

**I. Funding Opportunity Description 4**

Purpose 4

Background 4

National Priorities 5

Preparedness Principles 5

Integration of Preparedness Assistance 6

NBHPP Cooperative Agreement Requirements 8

**II. Award Information 13** Type of Award 14 Summary of Funding 14

**III. Eligibility Information 14**

1\. Eligible Applicants 14

2\. Cost Sharing/Matching 15

3\. Other 15

**IV. Application and Submission Information 15**

**1. Address to Request Application Package 15**

**Application Materials 15**

**2. Content and Form of Application Submission 16**

**Application Format Requirements 16**

**Application Format 16**

i\. Application Face Page 19

ii\. Table of Contents 19

iii\. Application Checklist 19

iv\. Budget 19

v\. Budget Justification 20

vi\. Staffing Plan and Personnel Requirements 21

vii\. Assurances 21

viii\. Certifications 22

**ix. Narrative 22**

a). Introduction 22

b). Program Summary and FY 2006 Goal Statement 22

c). Tiered Response Systems 23

d). Capability Based Planning 28

e). Methodology/Workplan 37

f). Resolution of Challenges 37

g). Evaluation and Technical Support 37

h). Organizational Information 37

**x. Attachments 37**

**3. Submission Dates and Times 38**

**4. Intergovernmental Review 39**

**5. Funding Restrictions 39**

**6. Other Submission Requirements 39**

**V. Application Review Information 41**

1\. Review Criteria 41

2\. Review and Selection Process 41

**VI. Award Administration Information 42**

1\. Award Notices 42

2\. Administrative and National Policy Requirements 42

3\. Reporting 43

4\. Performance Review 43

**VII. Agency Contacts 44**

**VIII. Tips for Writing a Strong Application 44**

**Appendix A -- Electronic Submission Guide 48**

**Appendix B -- Registering and Applying Through Grants.gov 63**

**Appendix C -- Relationship of Federal Preparedness Grants to Target
Capabilities 68**

**Appendix D -- FY 2006 Federal Preparedness Programs Allowable Cost
Matrix 69**

**Appendix E -- National Incident Management System (NIMS) Compliance
Activities for Hospitals (public and private) 74**

**Appendix F -- Targeted Funding to Urban Areas and Associated Sub-State
Regions 78**

**I. Funding Opportunity Description**

**PURPOSE**

> Through the Public Health and Social Services Emergency Fund, Congress
> authorized a response to bioterrorism and other public health
> emergencies in June 2002. The Public Health Security and Bioterrorism
> Preparedness and Response Act of 2002 (Public Law 107-188) amended the
> Public Health Service Act, adding Section 319C-1 (42 U.S.C. 247d-3),
> which supports activities related to countering potential terrorist
> threats to civilian populations. Funding is provided under the
> Consolidated Appropriations Act, 2005 (Public Law 108-447).
>
> P.L. 107-188 created the charge to prepare the country for a terrorist
> attack or public health emergency. The National Bioterrorism Hospital
> Preparedness Program (NBHPP) mission is enhance the ability of
> hospitals and supporting health care systems to prepare for and
> respond to bioterrorism and other public health emergencies. This
> guidance is the fifth provided under Section 319C-1 of the Public
> Health Service Act. The purpose of this document is to guide States in
> their development of a health care system capable of responding to an
> emergency that involves mass casualties and consequences.
>
> In FY 2006 the NBHPP will strive to ensure this program promotes a
> consistent tiered response structure within and among States that
> facilitates the movement of resources, people and services and
> enhances overall response capabilities.
>
> **BACKGROUND**

**THE NATIONAL PREPAREDNESS GOAL**

> On March 31, 2005, the Department of Homeland Security (DHS) issued
> the Interim National Preparedness Goal (the Goal). The Goal
> establishes a vision for national preparedness including National
> Priorities. The Target Capabilities List (TCL) identifies 37
> capabilities integral to Nation wide all hazards preparedness,
> including acts of terrorism. The national preparedness doctrine and
> operational foundation provided in these documents form the basis for
> Federal preparedness assistance going forward. The Goal is a
> significant evolution in the approach to preparedness and homeland
> security. It presents a collective vision for national preparedness,
> and establishes National Priorities to guide the realization of that
> vision to meet the most urgent needs. The Goal is a companion document
> to the National Response Plan (NRP), National Incident Management
> System (NIMS), and the interim National Infrastructure Protection Plan
> (NIPP).
>
> The Goal establishes a framework that guides entities at all levels of
> government in the development and maintenance of the capabilities to
> prevent, protect against, respond to, and recover from major events,
> including Incidents of National Significance as defined in the NRP.
> Additionally, the Goal will assist entities at all levels of
> government in the development and maintenance of the capabilities to
> identify, prioritize, and protect critical infrastructure and key
> resources as described in the NIPP.
>
> The Goal and the TCL are evolving documents that will be updated
> regularly to incorporate new threats, technologies, improvements to
> capability levels, new preparedness initiatives and priorities, and
> lessons-learned. DHS will coordinate the establishment of a structure
> and process for the ongoing management and maintenance of the Goal.
> This structure and process will be coordinated closely with the
> ongoing management and maintenance of the NIMS, NRP, and NIPP. Such
> coordination will ensure that national policy and planning for
> operations and preparedness are mutually supportive.

**NATIONAL PRIORITIES**

> The National Priorities in the Goal help guide the Nation's
> preparedness efforts to meet its most urgent needs. The priorities
> fall into two categories: (A) three overarching priorities that
> contribute to the development of multiple capabilities, and (B) five
> capability-specific priorities that build selected capabilities for
> which the Nation has the greatest need:
>
> Overarching:

-   Expanded Regional Collaboration

-   Implement the NIMS and NRP

-   Implement the Interim NIPP

> Capability-specific:

-   Strengthen Information Sharing and Collaboration Capabilities

-   Strengthen Interoperable Communications Capabilities

-   Strengthen Chemical, Biological, Radiological/Nuclear, and Explosive
    (CBRNE) Detection, Response, and Decontamination Capabilities

-   Strengthen Medical Surge and Mass Prophylaxis

-   National Review of Emergency Operations Plans and Status of
    Catastrophic Planning

> Health and medical issues are closely tied to several of the national
> priorities. During the past four years NBHPP funding has been made
> available to States for the purposes of addressing medical surge and
> mass prophylaxis. States have increased their healthcare system
> capacities to receive a large number of victims from either a man made
> catastrophe or a natural disaster. With several years of funding
> capacity building the focus turns to efforts to build the capability
> of the healthcare system to effectively manage a mass casualty event
> that results in fewer deaths, long term disabilities and required
> hospitalizations.

**PREPAREDNESS PRINCIPLES**

This guidance was built on the following four principles:

1)  **Coordination:** A tiered State/sub-State regional/local and
    inter-State response system is the foundation of healthcare response
    capability that outlines responsibility not authority during an
    emergency. A strong tiered response system promotes an atmosphere in
    which healthcare assets are collectively planned for and coordinated
    in a defined manner to create a more effective response.

> **2) Integration:** Planning for healthcare preparedness must be
> cognizant and reflective of other Federal efforts incorporating both
> risk and capability-based planning. Health and medical providers must
> plan, implement and evaluate their emergency operations plans with
> public health, fire protection, law enforcement and other emergency
> plans to establish a seamless response system.
>
> **3) Prioritization:** A viable response system based on community
> hazard vulnerabilities is the best tool to prioritize investments in
> preparedness. While each State will possess unique vulnerabilities and
> subsequent consequences, a biological event is common to all States
> and appropriate planning must take place at the State, sub-State
> regional and local level to prepare for an event such as pandemic
> influenza
>
> **4) Refinement:** Continuous quality improvement of the response
> capacity and capabilities of the healthcare system can be accomplished
> through exercising of plans using a multi-jurisdictional
> multi-disciplinary construct, refinement and dissemination of
> educational competencies that have been developed and better
> leveraging of resources.
>
> As frontline entities in response to mass casualty incidents,
> hospitals and other healthcare providers such as health centers, rural
> hospitals and private physicians will be looked to for minimizing the
> loss of life and permanent disabilities. Hospitals and other
> healthcare provider organizations must be able to work not only inside
> their own walls, but as a team during an emergency to respond
> efficiently. Hospitals respond to events which cause increased numbers
> of patients on a day-to-day basis and through empirical evidence have
> become very adept at flexing their systems in a response that meets
> the need during the event. Because we live under the threat of mass
> casualties occurring at any time and anywhere with consequences that
> may be different than the day-to-day occurrences, the healthcare
> system must be prepared to respond to these events by working as a
> team or community system. Attention and priorities must be placed on
> the development of a seamless, tiered response system that can only
> exist with mutual cooperation and collaboration. In order to
> accomplish this seamless tiered response capability, public and
> private healthcare entities must come together as one and work
> collaboratively with State emergency management, local fire and
> police, public health and other State governmental entities to
> maximize their capability and leverage funding for coordination,
> collaboration, integration, planning and evaluation.
>
> As a starting point, Hazard Vulnerability Assessments (HVA) completed
> in FY 2005 should be reviewed and utilized to determine the
> capabilities needed to handle the consequences of the emergency. In
> addition to developing capabilities for vulnerabilities identified in
> the HVAs, States must build their capability to effectively respond to
> a pandemic influenza. This will require close coordination with the
> State and Local Public Health Preparedness Directors for the Centers
> for Disease Control and Prevention (CDC) cooperative agreements.
>
> It is imperative that all systems are continually exercised and
> drilled to identify gaps or weaknesses so they can be addressed and
> strengthened. Hospitals must adopt an incident command system,
> continually train employees on the system and exercise the system to
> incorporate it in the system culture. In addition, hospitals and other
> healthcare providers should identify the link to the local incident
> management system. Exercises should be done in conjunction with other
> response agencies and organizations to best judge the entire response
> system and to leverage their funds.
>
> **INTEGRATING PREPAREDNESS ASSISTANCE**
>
> The Goal and the TCL establish a common planning framework in which
> agencies at all levels of government and across all disciplines can
> operate. This framework serves to guide agencies and their
> constituents in appreciating their unique contributions while working
> toward a goal shared by all. This new strategic framework provides the
> Nation with an opportunity to begin viewing programs that have
> traditionally been managed within one particular agency or discipline
> in a more holistic and connected manner. Only when programs are
> managed and implemented through an interdisciplinary and
> multi-jurisdictional approach can the Nation truly begin to operate in
> the coordinated fashion that an incident of national significance will
> demand.
>
> This opportunity is especially pertinent to the implementation of
> preparedness grant programs in DHS and HHS. In FY 2005, DHS and HHS
> made available approximately \$3.9 billion in grant and cooperative
> agreement funds to States and local jurisdictions to assist in
> building and sustaining national preparedness through several major
> grant programs, including:

Table 1 -- FY 2005 DHS/HHS Preparedness Programs

  ------------------------------ --------------------------- ------------
  Program Title                  Sponsoring Agency           FY 2005
                                                             Funding

  Homeland Security Grant        Office of Grants & Training \$2.5
  Program                        (G&T), DHS                  billion

  Public Health Emergency        Centers for Disease Control \$862
  Preparedness Cooperative       and Prevention, HHS         million
  Agreement                                                  

  National Bioterrorism Hospital Health Resources and        \$491
  Preparedness Program           Services Administration,    million
                                 HHS                         

  Bioterrorism Training and      Health Resources and        \$25 million
  Curriculum Development Program Services Administration,    
                                 HHS                         
  ------------------------------ --------------------------- ------------

> These grant programs target distinct, but related, homeland security
> stakeholders at the State and local levels. For example, the State
> Homeland Security Program within HSGP crosses all of the capabilities
> in the TCL, while the Law Enforcement Terrorism Prevention Program
> focuses specifically on the capabilities related to prevention
> efforts. Likewise, CDC's and HRSA's emergency preparedness programs
> center on 13 capabilities.
>
> Using the NPG and the corresponding structure of the TCL as the
> foundation, State and local homeland security, public safety, and
> public and private health organizations can continue to build the
> framework that connect them to one another to support the overall
> homeland security program.
>
> To emphasize the criticality of a coordinated approach to the
> management and application of these funding streams, DHS and HHS have
> established a Federal Preparedness Grant Program Steering Committee to
> strengthen the alignment of each agency's respective grant programs
> both with each other and within the new context of the NPG. Through
> this committee, DHS
>
> and HHS are working to align their programs and develop common
> language and analytical tools while maintaining the discreet focus
> areas for each program.
>
> States are likewise encouraged to examine how they are integrating
> preparedness activities across disciplines and agencies. In FY 2006,
> States must implement a cohesive planning framework that builds and
> implements homeland security initiatives that leverage DHS and HHS
> resources, as well as other Federal and State resources. In addition
> to DHS and HHS resources, grantees and subgrantees should consider
> preparedness assistance programs from other Federal agencies including
> the United States Department of Agriculture (USDA), Department of
> Justice (DOJ), and Department of Transportation (DOT). Specific
> attention should be paid to how all available preparedness funding
> sources can be effectively used in a collaborative manner to support
> the enhancement of capabilities throughout the State.
>
> States are encouraged to broaden membership of the Senior Advisory
> Committee to include membership from additional disciplines and
> associations and regional working groups. Broad membership will
> strengthen States ability to leverage Federal preparedness funding
> enabling the development of a holistic enterprise wide strategic
> approach to homeland security.[^1]

**NBHPP COOPERATIVE AGREEMENT AWARDEE REQUIREMENTS**

> Cooperative agreement awardees will fund activities that coordinate,
> integrate, prioritize and sustain improvements in healthcare
> preparedness that have been made since the initial NBHPP funding of
> FY2002.
>
> Applicants must address all core program requirements (A, B, C, D, E,
> F and G listed below).

[]{.mark}

> Program Requirements are:
>
> **A). All applications must contain a letter indicating:**

-   That this application was developed in coordination with the state
    hospital association or representative(s) of the healthcare
    community, and

-   That all planning will be conducted in a coordinated manner with the
    healthcare partners identified in this application.

> **B) Bioterrorism / Hospital Preparedness Coordinator (will be
> included in the Methodology section of the application)**
>
> NOTE: Awardees with vacancies in this position will have the funds
> budgeted for this position restricted until the position if filled.
>
> Since FY 2002 awardees have been required to designate a BT / Hospital
> Preparedness Coordinator dedicated to this cooperative agreement only.
> Minimum duties of the Coordinator include:

-   Responsibility for the day-to-day management of the HRSA cooperative
    agreement,

-   Serving as the principal point of contact for the HRSA project
    officer,

-   Coordinating with the CDC cooperative agreement awardee staff,

-   Coordinating with DHS State Administrative Agents (SAAs), and

-   Staying knowledgeable of needs assessments and operational plans for
    bioterrorism preparedness in the State.

> The incumbent should have training and experience in disaster response
> planning, including knowledge of clinical issues, administrative
> procedures, linkages to appropriate agencies and organizations, and
> training issues appropriate to bioterrorism preparedness.
>
> The amount of time and percentage of salary charged to the cooperative
> agreement must be spent in direct support of this program and its
> activities. The HRSA Coordinator should be paid for from HRSA
> cooperative agreement funds not other federal funds and should spend a
> minimum of 50% time in direct support of this cooperative agreement
> and its activities.
>
> Awardees will include a curriculum vita that describes the education,
> training and experience that qualify this person for the task. As in
> past years, HRSA does have a role in approving any candidates for this
> position.
>
> **C) Performance Measures and Reporting Activities**
>
> Successful applicants **are required** to report annually on
> performance measures. The performance measures developed for this
> program will be provided as a supplement to this guidance.
>
> Awardees will be required to submit two progress reports. The format
> and content of the reports will be transmitted at a later date and may
> contain additional reporting requirements that supplement the
> performance measures.
>
> **D) Data Collection Systems (these activities must be clearly
> delineated in the workplan of the application, if they are not funded
> and addressed awardee funding may be withheld.)**
>
> Evaluation of the improvements that have been made in preparedness is
> critical in order to provide quality healthcare response in the event
> of a bioterrorist attack, pandemic flu outbreak or other public health
> emergency. Therefore, cooperative agreement funding may be used to
> build the capability for Statewide and sub-State regional data
> collection relating to:

-   bed availability,

-   credentialed and privileged healthcare volunteers, and

-   the ability of States and sub-awardees to meet the performance
    measures outlined in supplemental guidance.

> Applicants are expected to clearly detail in their applications the
> status of current data collection systems and how these funds will be
> used to make their systems more comprehensive and integrated with
> existing systems used by other first responder agencies, if
> applicable.
>
> The standardization of data at all levels, relating to bed
> availability, and volunteer healthcare personnel throughout the U.S.
> is a vitally important endeavor, requiring that each State address, at
> a minimum, the following items within their cooperative agreement
> application to support this effort:

1.  **Hospital Available Beds for Emergencies and Disasters (HAvBED)
    System**

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1)  Bed tracking systems must possess the following capabilities:

    a.  Be able to report aggregate State level data to the HHS
        Secretary's Operation Center (SOC) no more often than twice
        daily when requested. The frequency of data required from the
        hospitals is dependent on the incident. The time necessary for
        data entry must be minimized so that it does not interfere with
        the other work responsibilities of the hospital staff during
        an MCI. Daily and weekly fluctuations in bed capacity. Ideally,
        all institutions would enter data at the same time on similar
        days in order to reduce variability due to these fluctuations.

    b.  Possess the following Hospital Identification Information:

        i.  Hospital Name

        ii. Name of Chief Administrator

        iii. Street Address

        iv. City

        v.  State

        vi. Zip Code

        vii. Area Code

        viii. Local Telephone Number

        ix. County

    c.  Be able to report on the following categories as defined in the
        HHS HAvBed system:

        i.  **Staffed Vacant / Available Bed Count:**

            1.  Intensive Care Unit (ICU)

            2.  Medical and Surgical (Med/Surge)

            3.  Burn Care

            4.  Peds ICU

            5.  Pediatrics (Peds)

            6.  Psychiatric (Psych)

            7.  Emergency Department (ED)

            8.  Negative Pressure Isolation

            9.  Operating Rooms

        ii. **Emergency Department Divert Status**

        iii. **Decontamination Facility Available**

        iv. **Ventilators Available**

> **Bed Definitions**

i.  **Physically Available Beds:** Beds that are licensed, physically
    set up, and available for use. These are beds regularly maintained
    in the hospital for the use of patients, which furnish
    accommodations with supporting services (such as food, laundry, and
    housekeeping). These beds may or may not be staffed but are
    physically available.

ii. **Staffed Beds:** Beds that are licensed and physically available
    for which staff members are available to attend to the patient who
    occupies the bed. Staffed beds include those that are occupied and
    those that are vacant.

iii. **Vacant/Available Beds:** Beds that are vacant and to which
     patients can be transported immediately. These must include
     supporting space, equipment, medical material, ancillary and
     support services, and staff to operate under normal circumstances.
     These beds are licensed, physically available, and have staff on
     hand to attend to the patient who occupies the bed.

iv. **Adult Intensive Care (ICU):** Can support critically ill/injured
    patients, including ventilator support.

v.  **Medical/Surgical:** Also thought of as "Ward" beds.

vi. **Burn or Burn ICU:** Either approved by the American Burn
    Association or self-designated. (These beds should not be included
    in other ICU bed counts.)

vii. **Pediatric ICU:** The same as adult ICU, but for patients 17 years
     and younger

viii. **Pediatrics:** Ward medical/surgical beds for patients 17 and
      younger

ix. **Psychiatric:** Ward beds on a closed/locked psychiatric unit or
    ward beds where a patient will be attended by a sitter.

x.  **Negative Pressure/Isolation:** Beds provided with negative
    airflow, providing respiratory isolation. Note: This value may
    represent available beds included in the counts of other types.

xi. **Operating Rooms:** An operating room that is equipped and staffed
    and could be made available for patient care in a short period.

> Further information on the HAVeBED system can be found at
> [[http://www.ahrq.gov/research/havbed/]{.underline}](http://www.ahrq.gov/research/havbed/)
>
> Use of these standardized definitions and estimates of future bed
> availability will provide greater consistency among hospitals in
> reporting bed availability information.
>
> **2. Emergency System for the Advance Registration System of Volunteer
> Health Professionals (ESAR VHP)**
>
> State-based ESAR VHP systems provide for registration, credential
> verification, and emergency utilization of volunteer health
> professionals in local, regional, and national disasters and public
> health emergencies.
>
> HRSA has published the Interim *ESAR-VHP Technical and Policy
> Guidelines, Standards and Definitions* (Guidelines) for the ESAR-VHP
> program. The Guidelines are a product of ten national working groups,
> composed of State (awardees), relevant Federal agency, association,
> and organizational representatives. The Guidelines cover the entire
> range of planning issues involved in establishing and operating an
> ESAR-VHP system, and are intended to be a framework for the
> development of all State systems. Sections include: State Planning,
> Authorities and Emergency Operations, System Design and Content,
> Recruitment and Retention of Volunteers, Credentialing, Privileging
> and Identification, Resource Typing, Training, Operations and
> Maintenance, Funding and Cost, Security and Privacy, Regionalizing and
> Nationalizing, and Common Definitions. HRSA expects to complete a
> final version of the Guidelines by the end of 2006; however, the
> Guidelines are intended to be a living document. It is anticipated
> that sections of the Guidelines will be continuously refined and
> updated as new information is available.
>
> **Examples of other appropriate activities in the Data Collection and
> Reporting category could include:**

-   Developing State capacity to collect data to determine the status
    and progress of the State and subrecipients in meeting the NBHPP
    performance measures. Sub-State collection measures are appropriate
    funding activities as well but awardees are reminded that the
    ultimate reporting requirements are the responsibility of the State
    or awardee.

-   Purchasing software, or hiring a consultant/contractor to develop
    internet-based PHIN compliant software systems to build
    infrastructure at the State, sub-State regional and local level for
    electronic collection and storage of data with the condition that
    the system be capable of transmitting State level data to the HHS
    and HRSA.

-   Purchasing software for use at the State, sub-State regional and
    local level with the condition that subrecipients commit to
    submitting data to the State in accordance with federal and State
    submission requirements.

> As cooperative agreement dollars for activities listed above are
> limited, applicants are encouraged to use this opportunity as a way to
> develop collaborations with other State/Federal funding sources and
> programs in an effort to increase the overall funds available for data
> system enhancement and better leverage the dollars offered through the
> NBHPP program.
>
> **E) Required Meetings (this must be clearly delineated in the line
> item narrative of the budget. If the funds fail to be allocated
> awardee funding may be withheld.)**
>
> **Annual Awardee Meeting:** Awardees are instructed to include funding
> in their budget for a minimum of three persons to attend the annual
> NBHPP grantee meetings (the BT Coordinator, a representative of the
> hospital association and another individual with a designated role in
> the cooperative agreement). Attendance at this meeting is a
> requirement of the NBHPP program. Participants need to budget for
> travel to the Washington, D.C. area for 3 nights/4 days. The meeting
> is anticipated to be 2 ½ days. Approximate hotel costs for Washington,
> D.C. area are \$153 per night/person.
>
> **F). National Incident Management Systems (NIMS) Compliance
> Activities**
>
> As stated in the FY 2005 HRSA NBHPP cooperative agreement funding
> guidance "as a condition of receiving National Bioterrorism Hospital
> Preparedness Program (NBHPP) support, awardees agree to adopt and
> implement the NIMS."
>
> As part of the FY 2006 application, applicants must submit a
> self-certification form attesting that the state, taken as a whole,
> has met the minimum FY 2005 requirements. This certification was
> already sent to the Department of Homeland Security via the State
> Administrative Agents and awardees are instructed to submit a copy of
> that certification with the application as **Attachment 1**.
>
> State certification is required to receive FY 2006 preparedness funds.
> "Taken as a whole" recognizes that not every community, individual
> responder or healthcare entity will have completed all of the
> requirements. The "taken as a whole" standard means that most have and
> that good faith efforts are underway to achieve full compliance.
>
> Awardees are further instructed to include a statement, as
> **Attachment 2**, that the state is adopting NIMS at the state/
> territorial level for all government departments and agencies; as well
> as promoting and encouraging NIMS adoption by associations, utilities,
> non-governmental organizations (NGOs) and private sector incident
> management and response organizations and hospitals. This will be
> verified through site visits conducted by HHS/HRSA staff related to
> the NBHPP program.
>
> HRSA can withhold funds to states that fail to certify that the FY
> 2005 requirements have been met.
>
> **G). Targeted Funds to Urban Areas and Associated Sub-state Regions**
>
> It is recognized that the majority of hospital care and the necessary
> specialty care for victims of bioterrorism or natural disasters lies
> in the major urban areas of each state and their outlying areas. To
> ensure a seamless coordinated response from the major urban areas to
> the outlying areas it is imperative that urban hospitals and health
> systems extend their operations into surrounding areas to move
> patients, share equipment, supplies and professionals. To encourage
> collaboration at the tier 2 and tier 3 levels in and around major
> urban areas, States will focus their efforts on a city and the
> surrounding sub-state regions (previously identified for the
> cooperative agreement) anchored by that city.
>
> States will provide designated major urban areas, and the surrounding
> sub-state regions (see appendix F), an increase of 10% for surge
> capacity and capability building over the FY 2005 funding spent in
> these areas. For example, if State A spent \$1,000,000 in the
> designated major urban area(s) and their sub-state region(s) in FY
> 2005, then at least \$1,100,000 must be spent in the major urban
> area(s) and surrounding sub-state region(s) in FY 2006.

**II. Award Information**

**TYPE OF AWARD**

> Funding will be provided in the form of cooperative agreements. HRSA
> responsibilities in the cooperative agreement, in addition to the
> required program monitoring and technical assistance provided include
> but are not limited to:

-   Making available the services of NBHPP personnel as participants in
    the planning and development of all phases of the project which
    include joint establishment of priorities as to where to direct
    technical assistance; setting priorities on national and regional
    meetings of significance to attend; input on surveys/questionnaires
    developed; and review of the semi-annual and year end reports on a
    state and national level.

-   Participating in the development of agendas for local and Advisory
    Committee meetings and emergency preparedness meetings conducted
    during the period of the Cooperative Agreement.

-   Reviewing and approving methods and timeline to be established for
    accomplishing the scope of work to include review of planned
    activities, performing site visits and discussing findings with
    grantee.

-   Assisting in the establishment of Federal interagency contacts that
    are also focused on data system development and linkage so that
    emergency preparedness development is integrated into these efforts.

-   Participating in the dissemination of project activities and
    products through utilization of the NBHPP agencies and list serves.

-   Facilitating effective communication and accountability regarding
    the NBHPP project with special attention to new program initiatives
    and policy development in the public health and medical field
    relating to NBHPP issues.

    **SUMMARY OF FUNDING**

The NBHPP will provide funding during Federal fiscal year (FY) 2006. The
anticipated project period and budget period will be Sept. 1, 2006 --
Aug. 31, 2007.

Approximately \$450,396,032 is expected to be available to fund 62
awardees for the activities outlined in this funding opportunity. The
NBHPP will notify all grantees as soon as possible once the funding
levels are determined.

**III. Eligibility Information**

**1. ELIGIBLE APPLICANTS**

Current awardees are eligible to apply for funding. They are: health
departments of all 50 States, the District of Columbia, the Nation's
three largest municipalities (New York City, Los Angeles county and
Chicago), the Commonwealths of Puerto Rico and the Northern Mariana
Islands, the territories of American Samoa, Guam and the U.S. Virgin
Islands, the Federated States of Micronesia, and the Republics of Palau
and the Marshall Islands. Awardees will be notified as to their FY 2006
funding amount in a cover letter. The distribution of funds will be to
the State or political subdivision of a State (cities and counties are
considered political subdivisions of States).

Hospitals of all kinds, outpatient facilities, health centers, rural
health facilities, Tribes, EMS and poison control centers should work
with the appropriate state health department to acquire funding through
this program. These entities are vital partners in the development and
sustainment of surge capacity and as such all states are encouraged to
work with them and other appropriate partners, to the extent possible.

**2. COST SHARING/MATCHING**

Not applicable to this award

> **3. OTHER**

Not applicable to this award

**IV. Application and Submission Information**

> **1. ADDRESS TO REQUEST APPLICATION PACKAGE**
>
> **APPLICATION MATERIALS**
>
> The application and submission process has changed significantly. HRSA
> is ***requiring*** applicants for this funding opportunity to apply
> electronically through Grants.gov. All applicants ***must*** submit in
> this manner unless the applicant is granted a written exemption from
> this requirement in advance by the Director of HRSA's Division of
> Grants Policy. Grantees must request an exemption in writing from
> <DGPClearances@hrsa.gov>, and provide details as to why they are
> technologically unable to submit electronically though the Grants.gov
> portal. Make sure you specify the announcement number 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:

(1) Downloading from <http://www.hrsa.gov/grants/forms.htm>

> Or
>
> \(2\) Contacting the HRSA Grants Application Center at:
>
> The Legin Group, Inc.
>
> 901 Russell Avenue, Suite 450
>
> Gaithersburg, MD 20879
>
> Telephone: 877-477-2123
>
> <HRSAGAC@hrsa.gov>
>
> Instructions for preparing portions of the application that must
> accompany Application Form 5161-1 appear in the "Application Format"
> section below.

**2. CONTENT AND FORM OF APPLICATION SUBMISSION**

> **APPLICATION FORMAT REQUIREMENTS**
>
> See Appendix A, Section 4 for detailed application submission
> instructions. These instructions must be followed.
>
> The total size of all uploaded files may not exceed the equivalent of
> 80 pages when printed by HRSA, approximately 10 MB. This 80-page limit
> includes the abstract, project and budget narratives, attachments, 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 page will not
    be counted towards the page limit.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

-   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 a particular attachment, place a table of contents
    page specific to that attachment at the beginning. Table of contents
    page will not be counted in the page limit.

  -----------------------------------------------------------------------
  **Attachment        **Attachment Description (Program Guidelines)**
  Number**            
  ------------------- ---------------------------------------------------
  Attachment 1        Copy of NIMS Certification Letter sent to
                      Department of Homeland Security

  Attachment 2        Statement of promoting and encouraging NIMS
                      adoption by Specific Agencies listed on page 12

  Attachment 3        Position descriptions (that include the roles,
                      responsibilities, and qualifications of proposed
                      project staff)

  Attachment 4        Biographical Sketches (for any key employed
                      personnel)

  Attachment 5        Letter stating application was developed in
                      coordination with the state hospital association or
                      representative(s) of the healthcare community (see
                      page 7)

  Attachment 6        Evidence of Non Profit status and invention related
                      documents, if applicable.

  Attachment 7        Line Item Budget Narrative Justification

  Attachment 8        Other Relevant Documents. Include here any other
                      documents that are relevant to the application,
                      including letters of support. Letters of support
                      must be dated. 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.

  Attachment 9        Tables, charts, etc. Other significant documents to
                      provide further information about the proposal, not
                      included elsewhere in the table of contents
  -----------------------------------------------------------------------

**i. APPLICATION FACE PAGE**

> Use 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 93.889.
>
> **DUNS NUMBERS**
>
> All applicant organizations are required to have a Data Universal
> Numbering System (DUNS) number in order to apply for a grant from the
> Federal Government. The DUNS number is a unique nine-character
> identification number provided by the commercial company, Dun and
> Bradstreet. There is no charge to obtain a DUNS number. Information
> about obtaining a DUNS number can be found at
> [http://www.hrsa.gov/grants/dunsccr.htm](http://www.hrsa.gov/grants/preview/dunsccr.htm )
> or call 1-866-705-5711. Please include the DUNS number in item 8c of
> the SF-424/5161 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](http://www.hrsa.gov/grants/preview/dunsccr.htm ).
>
> **ii. TABLE OF CONTENTS**
>
> The application should be presented in the order of the Table of
> Contents provided earlier. Again, for electronic applications no table
> of contents is necessary as it will be generated by the system. (Note:
> the Table of Contents will not be counted in the page limit).
>
> **iii. APPLICATION CHECKLIST**

Use application Form 5161-1 provided with the application package.

**iv. BUDGET**

Use application Form 5161-1 provided with the application package.

> Please complete sections A and B of SF 424A with specific instructions
> that follow.

[]{.mark}

**Form SF-424A Specific Instructions: Detailed Budget Required**

> These forms will represent the full one-year project period of Federal
> assistance requested. If additional information and/or clarification
> are required, please contact the Grants Management Specialist
> identified in section VII of this guidance titled "Agency Contacts."
>
> Use the accompanying instructions. This form contains sections A
> (Budget Summary) through F (Other Budget Information). For each part
> of Section B, Budget Categories, it is required that applicants submit
> on additional sheet(s) a justification for each individual budget
>
> category itemized (6a-j). Applicants typically identify the specific
> needs but often fail to write a justification of those needs. These
> detailed budget justifications require the applicant to show specific
> references to the project plan that would relate to how the requested
> dollar amount was developed.
>
> If the applicant plans to enter into a contract, the applicant's
> budget justification should include an itemized budget (direct and
> indirect costs) for each contractual agreement as well as a summarized
> scope of work. The total budget for each subcontract should be
> reflected in the applicant's itemized budget under the "Contractual"
> budget item. Grantees must perform a substantive role in carrying out
> project activities and not merely serve as a conduit for an award to a
> contractor.
>
> **v. BUDGET JUSTIFICATION**
>
> Provide a narrative that explains the amounts requested for each line
> in the budget. The budget justification should specifically describe
> how each item will support the achievement of proposed objectives. The
> budget period is for ONE year. 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.
>
> **Allowable Costs**
>
> The NBHPP may support reasonable and necessary costs of cooperative
> agreement projects within the scope of approved activities. Allowable
> costs may include salaries, equipment and supplies, travel, contracts,
> consultants, and other direct costs, as well as indirect costs. The
> NBHPP adheres to administrative standards reflected in the Code of
> Federal Regulations, 45 CFR Part 92 and 45 CFR Part 74.
>
> Include the following in the Budget Justification narrative:
>
> ***Personnel Costs**:* list all individuals being compensated for
> salary and/or fringe benefits under Federal project dollars with their
> title and role described. Indicate the percentage of yearly salaries
> and fringe benefits funded under this project.
>
> [Awardees are reminded that the NBHPP still adheres to a
> fifteen-percent cost cap on all direct costs that collectively include
> personnel, fringe, travel, supplies and equipment.]{.underline}
>
> ***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, and administrative salaries. If
> an organization applying for an assistance award does not have an
> indirect cost rate, the applicant may wish to obtain one through HHS's
> Division of Cost Allocation (DCA).  Visit DCA's website at:
> <http://rates.psc.gov/> to learn more about rate agreements, the
> process for applying for them, and the regional offices which
> negotiate them.
>
> ***Fringe Benefits**:* List the components that comprise the fringe
> benefit rate, for example health insurance, taxes, unemployment
> insurance, life insurance, retirement plan, tuition reimbursement. The
> fringe benefits should be directly proportional to that portion of
> personnel costs that are allocated for the project.
>
> ***Consultant Costs**:* Give name and institutional affiliation,
> qualifications of each consultant, if known, and indicate the nature
> and extent of the consultant service to be performed. Include expected
> rate of compensation and total fees, travel, per diem, or other
> related costs for each consultant.
>
> ***Travel**:* List travel costs according to local and long distance
> travel. For local travel, the mileage rate, number of miles, reason
> for travel and staff member/consumers completing the travel should be
> outlined. The budget should also reflect the travel expenses
> associated with participation in meetings and other proposed trainings
> or workshops such as the annual awardee meeting. Include funding in
> the budget for a **minimum of three persons** to attend the NBHPP
> Awardee meeting (the BT / Hospital Preparedness Coordinator, a
> representative of the hospital association and another individual with
> a designated role in the project). Attendance at this meeting is a
> **requirement** of the NBHPP grant program.
>
> Listed below is information cost estimates that applicants may find
> helpful in preparing the cost estimates for their application.
>
> 2006-2007: Grantee Meeting
>
> Lodging: 3 nights; Per Diem: 4 days
>
> Travel to Washington, D.C. area
>
> ***Equipment**:* Clearly explain and justify each piece of equipment,
> indicating the purpose and cost of each item being requested.
>
> ***Supplies**:* List the items that the project will use, e.g., office
> supplies, educational supplies, computer supplies, etc. Office
> supplies could include paper, pencils, and the like. Educational
> supplies may be pamphlets and educational videotapes. Remember, they
> must be listed separately. All supplies must have their costs listed
> and their need justified.
>
> ***Subcontracts**:* If a Subcontract is being requested, provide a
> separate budget justification. Complete this contractual budget
> justification in the same manner as the overall project budget
> justification. List and explain all expenses in detail.
>
> ***Other**:* Software related to Data Activities; publication costs;
> fees provided to speakers at meetings convened in relation to this
> grant.

**vi. STAFFING PLAN AND PERSONNEL REQUIREMETS**

> 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. ASSURANCES**
>
> The fourth section of Application Form 5161-1 contains SF 424B and SF
> 424D, and concerns **Assurances**. NBHPP applicants need to complete
> only **SF 424B** provided with the application package.
>
> **viii. CERTIFICATIONS**
>
> The fifth section of Form 5161-1 deals with **Certifications** and
> sets forth certain requirements for grantees which have been
> legislatively implemented since the SF-424 assurances pages were last
> revised. This section must be completed by all applicants and is
> provided with the application package.

**ix. PROGRAM NARRATIVE**

> This section provides a comprehensive framework and description of all
> aspects of the proposed program. It should be succinct,
> self-explanatory and well organized so that reviewers can understand
> the proposed project. Awardees should assume that reviewers will have
> limited or no prior knowledge of hospital preparedness work to date.
>
> The outcome of the objective cooperative agreement review process
> depends solely on information provided in the program narrative. The
> reviewers are required to evaluate a proposal based only upon the
> information provided in the application. Any other information may not
> be considered in the review.
>
> Attachments are used to provide supporting documentation such as
> tables, charts, position descriptions, biographical sketches, and
> letters describing participation and support. Substantive information
> corresponding to the review criteria must be contained within the
> program narrative.

a)  **Introduction**

> The following guidance lays out a six tiered response system,
> discusses the components of each tier and asks awardees to describe or
> discuss how their States tier system is structured. Each State will
> describe their current system as well as gaps and challenges. States
> will describe how they and appropriate stakeholders intend to fill the
> gaps.
>
> Use the following section headers as outline for writing the Narrative
> portion of the application. Applications that fail to follow this
> format will have difficulty during the objective review process and as
> a result may not be awarded full funding.
>
> For the past four years the NBHPP has focused on building specific
> capacities in the healthcare system to enable an effective response to
> many types of disasters. In FY 2006, it is evident that much progress
> has been made in the building of those capacities and the time has
> come to refocus attention of the healthcare community on building a
> capability-based Tiered Response System. In that vein, the program is
> moving to capabilities based planning. This program realignment is
> consistent with other Federal preparedness programs and will enable
> States, sub-State regions and local areas to integrate their plans
> across multiple disciplines and jurisdictions, implement healthcare
> response plans in a coordinated and succinct fashion, and provide a
> level of commonality across the country.
>
> This realignment continues to build on the work of the past four
> years. It is the intention that this system will provide a
> comprehensive and common framework in which to house and organize all
> that work and the activities described within this guidance to move
> the country forward.

b)  **Program Summary and FY 2006 Goal(s) Statement**

> Awardees should provide a three to five page overview of progress made
> in the past four years with NBHPP funding, challenges that have been
> encountered and a goal(s) for the coming funding cycle. Goal(s) should
> be specific, measurable, attainable and time framed.

c)  **Tiered Response Systems**

> The following diagram was published by the Department of Health and
> Human Services in 2004 in a manual entitled *Medical Surge Capacity
> and Capability: A Management System for Integrating Medical and Health
> Resources During Large- Scale Emergencies.* The manual provides a
> blueprint for healthcare response that is being adopted by the NBHPP.
>
> It should be noted that this concept does not differentiate between
> funded entities and non-funded entities; therefore when addressing
> these sections awardees should describe the system as a whole as it
> exists in the State.
>
> Awardees will use this section to clearly articulate the tiered
> regional response capability that exists in the State according to the
> following structure and nomenclature. Given the previous four years of
> funding awardees are expected to describe the system that exists in
> their State through Tier 5 which should include the state's
> integration with Federal response.
>
> For tiers 2, 3, and 4 awardees should explain, to the extent possible,
> the coordination/integration with the capabilities established in
> local jurisdictions through the DHS funded Metropolitan Medical
> Response System (MMRS) Program, regionally through the DHS funded
> Urban Area Security Initiative (UASI) urban areas, and at the State
> level, the DHS State Homeland Security Grant Program (SHSG).

![](media/image1.png){width="6.080555555555556in"
height="5.427777777777778in"}

> *Medical Surge Capacity and Capability: A Management System for
> Integrating Medical and Health Resources During Large- Scale
> Emergencies.* August 2004, CNA Corporation through a contract with US
> Department of Health and Human Services.
>
> The six-tier construct above depicts the various levels of health and
> medical asset management during response to mass casualty or complex
> incidents. The tiers range from the individual healthcare facility
> (HCF) and its integration into a local healthcare coalition
> (hospitals, clinics, health centers and other points of entry into the
> healthcare system that exist within the HRSA defined sub-State regions
> previously established for this cooperative agreement), to the
> coordination of Federal assistance. Each tier must be effectively
> managed internally in order to coordinate and integrate externally
> with other tiers.
>
> **Tier 1** -- **Management of Individual Healthcare Assets**
>
> Tier 1 is the primary site of hands-on medical evaluation and
> treatment. It includes hospitals, integrated healthcare systems,
> clinics, alternative care facilities, private practitioner offices,
> nursing homes with medical services, hospice, rehabilitation
> facilities, psychiatric and mental health facilities, and Emergency
> Medical Services (EMS). The Medical Reserve Corps and State and
> Federal healthcare assets (e.g., Veterans Affairs Hospitals) that are
> co-located within a jurisdiction also fall into Tier 1 because they
> may become local assets for emergency response.
>
> To maximize overall MSCC, efforts must extend beyond optimizing
> internal HCF operations and focus on integrating individual HCFs with
> each other and with non-medical organizations. Patient evaluation and
> care in emergencies or disasters is provided primarily at
> community-based hospitals, integrated healthcare systems, private
> physician offices, and other point-of-service medical facilities.
> These assets, therefore, must be centrally involved in the development
> of MSCC strategies. Such integration ensures that decisions affecting
> all aspects of the community response are made with direct input from
> medical practitioners, thus establishing medical care, along its
> continuum, as an essential component of incident management.
>
> The basic capability of Tier 1 is to maximize medical surge capacity
> and capability (MSCC) within each healthcare asset ensuring the safety
> of personnel and other patients, and the integrity of the facility.
> This is best accomplished by optimizing an entity's emergency
> operation plan to effectively manage internal resources and to
> integrate with external response assets and partners.

1.  Describe how healthcare assets maximizes medical surge capacity and
    capability (MSCC) ensuring the safety of personnel and other
    patients, the integrity of the facility, manages internal resources
    and integrates with external response assets and partners.

2.  Awardees will provide a map of the State that clearly delineates
    sub-State regions as well as the locations of the healthcare
    entities in the area.

> **Tier 2 -- Management of the Healthcare Coalition**
>
> The healthcare coalition organizes individual healthcare assets into a
> single functional unit. Its goal is to maximize MSCC across the
> coalition through *cooperative planning*, *information sharing, and
> management coordination*. The coalition ensures that health and
> medical assets have the information and data they need at a level of
> detail that will enable them to optimally provide MSCC.
>
> In addition to hospitals, the coalition may include long-term care
> facilities, rural healthcare facilities, private physician offices,
> clinics, health centers and any other health or medical asset that may
> be brought to bear during a major medical response. Its reach may
> extend beyond the geographic area of the primary responding
> jurisdiction (Tier 3), especially in rural settings.
>
> An integral component of the coalition response is medical mutual
> aid---the redistribution of personnel, facilities, equipment, or
> supplies to HCFs in need during times of crisis. Mutual aid provides
> surge capacity and capability that is immediately operational,
> reliable, and cost-effective.
>
> The basic capability of Tier 2 is to establish a coalition of
> healthcare entities within a defined geographic area to provide a
> mechanism to formally establish processes for requesting and receiving
> mutual aid during preparedness planning. It also allows such issues as
> staff credentialing, liability, reimbursement, and transfer of patient
> responsibility to be addressed in preparedness planning, thus ensuring
> a rapid distribution of aid when it is needed.

1.  Describe how the healthcare facilities within the defined sub-State
    regions, already established for this cooperative agreement,
    coordinate the utilization and or movement of medical resources
    (e.g., personnel, facilities, equipment, supplies) to sites of
    greatest need inside and outside of the sub-State region.

2.  Discuss mutual aid and cooperative agreements among healthcare
    facilities (HCFs) within those sub-State regions and how those
    regions interface with each other. Discuss how these sub-State
    regions interface with the jurisdiction's incident management
    system.

> **Tier 3 -- Jurisdiction Incident Management**
>
> Jurisdiction incident management (Tier 3) is the primary site of
> integration of healthcare facilities (HCFs) with fire/EMS, law
> enforcement, emergency management, public health, public works, and
> other traditional response agencies. It provides the structure and
> support necessary for medical assets to maximize MSCC, and it allows
> direct input by medical representatives into jurisdictional action
> planning and decision-making. In addition, it links local medical
> assets with State and Federal support.
>
> It is the most critical tier for integrating the full range of
> disciplines that may be needed in a mass casualty or complex medical
> event. The focus of Tier 3 is to describe how to effectively
> coordinate and manage diverse disciplines in support of medical surge
> demands. This requires healthcare assets to be recognized as integral
> members of the responder community and to participate in management,
> operations, and support activities. In other words, health and medical
> disciplines must move from a traditional support role based on an
> Emergency Support Function (ESF), of the NRP, to part of a unified
> incident management system. This is especially important during events
> that are primarily health and medical in nature, such as infectious
> disease outbreaks.
>
> The basic capability of Tier 3 is the integration of health and
> medical assets into the functional organization of incident management
> in the traditional emergency response community. This is accomplished
> through a well-organized and tested jurisdiction Emergency Operations
> Plan (EOP).

1.  Discuss how healthcare facilities, within the defined sub-State
    regions already established for this cooperative agreement,
    integrate with other response disciplines (e.g., public health,
    public safety, emergency management) through an

> incident management system to maximize jurisdictional medical surge
> capacity and capability.

2.  Describe the activities undertaken to date to train and exercise
    hospital and other healthcare provider staff in the National
    Incident Management System (NIMS) and how healthcare incident
    management system fits into the jurisdictional emergency management
    system.

> **Tier 4 -- Management of State Response and Coordination of
> Intrastate Jurisdictions**
>
> Tier 4 encompasses all State agencies that are responsible for
> emergency management, public health, and public safety preparedness
> and response. It addresses situations in which the State is considered
> the lead incident management authority, and those in which the State
> coordinates multi jurisdictional incident management (Tier 3).
>
> The basic capability of Tier 4 is to ensure that the State Emergency
> Management Program (EMP) fully integrates public health and acute-care
> medicine with traditional response disciplines (e.g., fire/EMS, law
> enforcement). An important focus of the State EMP should be developing
> management processes that facilitate integration between State-based
> and local or jurisdictional authorities.

1.  Describe State-level processes, tools, and/or systems that
    coordinate incident management activities among affected sub-State
    jurisdictions and/or coordinate mutual aid support.

2.  Discuss any standardized procedures that have been developed for
    reporting medical and health data (i.e., what, when, where, and how)
    and for requesting mutual aid.

> **Tier 5 -- Interstate Regional Management Coordination**
>
> Tier 5 describes the processes by which States assist one another and
> coordinate management and response activities during times of crisis.
> It includes State-level agencies that oversee emergency management,
> public health, medical and public safety emergency preparedness and
> response.
>
> Tier 5 describes how to maximize interstate coordination to support
> MSCC. In the past, interstate coordination generally depended on ad
> hoc arrangements, goodwill at the time of an incident, and other
> less-than predictable mechanisms. However, this changed when Congress
> enacted the Emergency Management Assistance Compact in 1996 (Public
> Law 104-321). EMAC, as it is commonly known, has now been accepted by
> almost all States and provides legal authority, financial mechanisms,
> and operational guidance to establish the ability to request and
> receive emergency assistance from other States.
>
> The basic capability of Tier 5 is establish and ensure effective
> regional response through an open exchange of information, incident
> management coordination, and mutual aid support.

1.  Describe how your State maximizes interstate coordination to support
    medical surge capacity and capability in terms of movement of
    patients, equipment, personnel and other response components.
    Awardees should also address the use of interstate drills and
    exercises.

2.  Describe how your state integrates with the Federal response under
    ESF 8 of the NRP**.**

> Applicants will describe what currently exists in terms of the
> flexibility of these tiers to address four scenarios. All awardees
> **must** address pandemic influenza and an explosive event as two of
> the system flexibilities and then choose two (2) of the highest ranked
> scenarios from the Hazard Vulnerability Assessment (HVA) performed
> during the FY 2005 budget cycle. Awardess must clearly articulate what
> the additional two scenarios are that are being addressed and the
> rationale behind these selections. In addition to addressing the
> system flexibilities that will change to meet different scenarios,
> awardees should also incorporate the differences needed for personnel,
> equipment, supplies and other capabilities to address the scenarios.

d)  **Capabilities Based Planning**

> Implementing a common, shared approach to achieving national
> preparedness requires the Nation to re-orient its programs and efforts
> in support of the National Preparedness Goal and the National
> Priorities. The Goal establishes a vision for preparedness, identifies
> Target Capabilities, provides a description of each capability, and
> presents guidance on the levels of capability that Federal, State,
> local, and Tribal entities will be expected to develop and maintain.
> Capabilities-based planning is a process by which to achieve the Goal
> and the capabilities it outlines. Capabilities-based planning is
> defined as, "planning, under uncertainty, to provide capabilities
> suitable for a wide range of threats and hazards while working within
> an economic framework that necessitates prioritization and choice."
> This planning approach assists leaders at all levels to allocate
> resources systematically to close capability gaps, thereby enhancing
> the effectiveness of preparedness efforts. Capabilities-based planning
> will provide a means for the Nation to achieve the Goal and National
> Priorities by answering three fundamental questions: "How prepared do
> we need to be?", "How prepared are we?", and "How do we prioritize
> efforts to close the gap?" At the heart of the Goal and the
> capabilities-based planning process is the TCL. The capabilities
> included in the TCL are listed in Figure 1.
>
> The capabilities-based planning process makes significant use of the
> TCL which provides additional levels of detail on the underlying tasks
> and resources for achieving these capabilities. Each level of
> government or geographic area will not be expected to develop and
> maintain all 37 capabilities to the same level. Capability-based
> planning necessitates the prioritization of resources and initiatives
> among the various capabilities. Given limited time and resources,
> jurisdictions will be expected to target their planning efforts on the
> most critical capability gaps. The expectation will vary based upon
> the risk and needs of different levels of government and geographic
> areas. Community hazard vulnerability assessments completed in FY 2005
> will drive the capabilities needed by the local, regional and State
> entities. For example, a community with a toxic chemical manufacturer
> must utilize the HVA, measure the potential health consequences of a
> chemical release and develop/acquire the capabilities needed for the
> health system response to the specific consequences.
>
> Applicants will describe what currently exists in terms of the
> capability elements for four scenarios. All awardees **must** address
> pandemic influenza and an explosive event as two of the system
> flexibilities and then choose up to two (2) of the highest ranked
> scenarios from the Hazard Vulnerability Assessment (HVA) performed
> during the FY 2005 budget cycle. Awardess must clearly articulate what
> the additional two scenarios are that are being addressed and the
> rationale behind these selections.
>
> For each of the capability elements listed below there are a number of
> components associated with that element that awardees must address in
> the application. It must be noted that each of the categories must be
> addressed; if a category is left unaddressed it may affect the overall
> award and review of the application. Components have been color coded
> and a legend provided that explains:

-   Which components are to be prioritized in terms of applying funds
    and activities to accomplish,

-   Which components will be eligible for funding but must be clearly
    linked to an HVA and gap analysis to show that there is still an
    unmet need, and

-   Which components are required but should require little money to
    accomplish.

> Personnel **-- ESAR VHP** / EMAC / MRC / Other volunteers / Medical
> Advance or Strike Teams
>
> Planning **-- Alternate Care Sites (AHRQ Site selection tool)** /
> Mobile Medical Facilities/ Mass Fatality Plans/ Evacuation Plans
>
> Equipment and Systems **--** **Bed Availability Tracking System
> (HAVBED/AHRQ)** / Patient Tracking and Movement / *Decontamination /
> Isolation / Pharmaceutical Caches* / **Interoperable Communications**
> / *PPE* / **Hospital Labs**
>
> **Training --** Competency based
>
> **Exercises, Evaluations and Corrective Actions --** Awardees will
> have to demonstrate their capabilities through State and sub-State
> regional exercises.
>
> **Bold** -- Priorities for FY 2006
>
> *Italicized* -- Components / Priorities that need to be clearly linked
> to an HVA and gap analyses to prove an ongoing unmet need, for further
> funding
>
> Normal font -- Components / Priorities that should require smaller
> amounts of money to accomplish
>
> **Personnel**

a.  **Hospital BT Coordinator ( see page 8)**

b.  **ESAR VHP (required of all awardees)** -- All States have received
    supplemental awards to begin building State-based volunteer
    registries. As was witnessed in the hurricanes of 2005, volunteer
    registration systems with advance credential verification are
    indispensable in quickly identifying and providing qualified
    healthcare personnel to respond in various areas of the country.
    Awardees must continue to build and (test) these State systems to
    ensure their effective intra- and inter-State operability. Awardees
    will describe:

-   Current status of the ESAR VHP integrated system for the advance
    registration and credential verification of volunteer healthcare
    professionals;

-   Current status of EMAC, Medical Reserve Corps, and other mutual aid
    agreements that exist for volunteers, and the degree to which these
    efforts are integrated into the ESAR VHP system;

-   The ability of the ESAR VHP system to register and verify
    credentials of health professionals participating in structured
    State-based emergency response teams as well as individual
    volunteers;

-   The ability of the ESAR VHP system to share data across State lines
    and with Federal partners;

-   Current status of State plans in place for deploying health
    volunteers;

-   Current status of mutual aid compacts and MOUs with other
    healthcare, public health and first responder agencies to maximize
    health professional surge capacity; and

-   Activities to be undertaken during this funding cycle to further the
    development of an operational ESAR VHP system.

> Additional activities for funding consideration under this capability
> include:

-   Development of medical strike teams either at the facility level or
    teams to go out of the facilities.

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-   Development of mutual aid compacts and MOU with other healthcare,
    tier 2 and tier 3 public health and first responder agencies to
    maximize surge

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-   Development and operationalization of ESAR VHP systems

> **Planning**

a)  **Alternate Care Sites (required of all awardees) --** Awardees must
    have the ability to provide surge capacity outside of the hospital
    setting as has been demonstrated through recent public health
    emergencies. Many States have undertaken very thoughtful and
    deliberate processes for identifying off site or alternate care
    sites within a certain radius of healthcare facilities. An important
    concept for States to keep in mind is that while selecting these
    sites planning must consider that Federal assets exist that can be
    brought to bear but require an "environment of opportunity" for set
    up and operation and may not be available for 72 hours. Awardees
    should clearly articulate:

-   How many sites have been identified at the State and sub-State
    regional level?

-   What type of facilities are being considered?

-   What can the facilities accommodate in terms of the numbers of
    patients and level of care, (i.e. triage, basic care and
    stabilization, trauma level type care, patients transferred from
    hospitals, medical needs shelters etc)?

-   What staffing plans have been developed for these facilities?

-   What are the plans for supply and re-supply of the facilities?

-   What are the plans for the security of the site? and

-   What are the plans for patient movement to the sites and from the
    sites to more definitive care sites either within or outside of the
    State?

b)  **Mobile Medical Facilities --** Awardees must have the ability to
    surge outside of the hospital or healthcare system has been
    demonstrated through recent public health emergencies. Awardees are
    not required to purchase mobile medical facilities but for some
    jurisdictions this may be a viable option until large population
    centers can be evacuated to outlying less affected areas with intact
    healthcare delivery systems. Awardees will describe:

-   What activities have been undertaken to establish mobile medical
    facilities in the State?

-   What activities have been undertaken to provide for the staffing,
    supply and re-supply of the facilities and associated training of
    medical teams associated with these facilities?

-   If these facilities exist in the State how many of them are
    available, where are they positioned?

-   What are they capable of handling in terms of numbers of patients
    and level of care provided (triage, primary care, tertiary care,
    trauma etc)

-   What capabilities do they possess (i.e., Do they posses the
    capability to perform surgery? Do they have a lab? Can they provide
    x-ray services? Do they posses an ICU? Do they have pharmacy
    services?)

-   How long can these assets be deployed to the field before they would
    need to be re-supplied?

-   What plans, MOU's and other arrangements exist for the transfer and
    use of the facilities and any associated medical teams, equipment
    and supplies within the State and between adjoining States as may be
    needed in an emergency?

> Additional activities for funding consideration under this capability
> include:

-   Development of facility based Fatality Plans for hospitals and other
    healthcare entities.

-   Development or refinement of patient evacuation plans. This also
    includes air and ground transportation of patients requiring
    referral to hospitals for specialty care not available at the
    receiving hospital and integration with Federal capabilities.

-   Costs associated with the selection and certification of alternative
    care sites.

> **Equipment and Systems**

a)  **Bed Availability Tracking System (required of all awardees) --**
    As Stated on page 8 of the guidance, the development and enhancement
    of bed tracking systems are a required activity for all awardees.
    Characteristics have been outlined that all systems must contain
    whether or not bed tracking currently exists. In addition awardees
    will discuss:

-   What activities to date have been undertaken to develop bed tracking
    systems at the State, sub-State regional and local level?

-   If bed tracking systems currently exist in the State are the systems
    capable of reporting on the bed types as outlined in the Program
    Requirements section of this guidance?

-   How the tracking system is implemented during an event, how many
    times a day reports are asked for and the chain of reporting that
    happens from the hospital level to the State EOC?

b)  **Interoperable Communication Systems (required of all awardees)
    --** Another integral component to successful healthcare
    preparedness and response is an integrated interoperable
    communication system that links hospitals, EMS and other healthcare
    entities with public health at a minimum and other first response
    partners. By definition, communications interoperability refers to
    the ability of public safety agencies to talk across disciplines and
    jurisdictions via radio communications systems, to exchange voice
    and/or data with one another on demand, in real time, when needed,
    and as authorized.

> When procuring equipment for communication system development and
> expansion, a standards-based approach should be used to begin
> migration to multi-jurisdictional and multi-disciplinary
> interoperability. Specifically, all new voice systems should be
> compatible with the ANSI/TIA/EIAA-102 Phase 1
>
> (Project 25 or P25) SAFECOM suite of standards. This recommendation is
> intended for government owned or leased land mobile public safety
> radio equipment and its purpose is to make sure that such equipment or
> systems are capable of interoperating with other public safety land
> mobile equipment or systems.
>
> The first priority of Federal funding for improving public safety
> communications is to provide basic, operable communications within a
> department with safety as the overriding consideration. Funding
> requests by agencies to replace or add radio equipment to an existing
> non- P25 system will be considered if there is an explanation as to
> how their radio selection will allow for improving interoperability or
> eventual migration to interoperable systems. This guidance does not
> preclude funding of non-Project 25 equipment when there are compelling
> reasons for using other solutions. Absent these compelling reasons,
> SAFECOM intends that Project 25 equipment will be preferred for
> digital systems to which the standard applies. The SAFECOM grant
> guidance materials are available in their entirety on the SAFECOM
> website in the electronic library. [http:///www.safecomprogram.gov]()
> OR
>
> <http://www.safecomprogram.gov/SAFECOM/library/grant/1016_safecomgrant.htm>
>
> Awardees will address:

-   What protocols exist at the State, sub-State regional and local
    levels for redundancy in communications systems to ensure
    communication during an event when power is lost and facilities
    possibly become isolated from other entities?

-   What training/education on the equipment and protocols takes place
    for personnel involved with a response to include efforts
    incorporating communication plans in tabletop or operational
    exercises?

-   What primary and secondary communication capabilities exist for
    patient tracking and information dissemination between healthcare
    and other response entities?

-   What are the means for establishing and exchanging voice
    communications amongst participating hospitals and healthcare
    organizations in any given region/State (i.e., dedicated radio
    frequency and radios, VOIP, satellite phones)? and

-   What are the means for establishing and exchanging data information
    amongst participating hospitals and healthcare system in any given
    region/State?

c)  **Hospital Laboratories (required of all awardees) --** Awardees
    will expand upon efforts that have been underway for the past 3
    years, but in addition to these activities hospital labs need to be
    ready to handle the increase in diagnostics that will need to be
    reported to local health departments and labs within the Laboratory
    Response Network (LRN) on a 24-7-365 basis. Awardees will discuss:

-   What systems are currently in place to ensure hospital labs have the
    capability to report and receive reports 24-7 with local health
    departments and LRN sites?

-   How are lab personnel incorporated into drills and exercises on
    terrorism preparedness?

-   Discuss the numbers of laboratories and the Biological Safety Levels
    (BSL) of them in your State and how these laboratories will
    interface with hospitals.

> Additional activities for funding consideration under this capability
> include:

-   Security **upgrades** to existing facilities. Since all JCAHO
    hospitals are required to have security as part of JCAHO
    accreditation, the NBHPP will **no longer fund new** security
    systems for facilities. Upgrades to existing systems may be
    requested but must be clearly linked to the activities in this
    application.

-   Upgrades to hospital lab systems to enhance the ability to receive,
    handle, package and ship suspicious samples, as well as to
    accommodate the increased reporting and receiving of data with
    multiple entities to include public health, LRN labs and others.

-   Enhancement of interoperable communications systems.

-   Enhancement of or development of bed tracking systems that are
    consistent with the standards in this guidance.

-   Upgrades and enhancements to PPE, Isolation and Decontamination
    equipment that are clearly linked to HVAs and gap analyses that show
    where and why sufficient quantities do not currently exist

-   Developing State capacity to collect and analyze data to determine
    the status and progress of the State and subrecipients in meeting
    the NBHPP performance measures. Sub-State collection measures are
    appropriate funding activities as well but awardees are reminded
    that the ultimate reporting requirements are the responsibility of
    the State or awardee.

-   Purchasing software, or hiring a consultant/contractor to develop
    internet-based software systems to build infrastructure at the
    State, sub-State regional and local level for electronic collection
    and storage of data with the condition that the system be capable of
    transmitting State level data to the HHS.

-   Purchasing software for use at the State, sub-State regional and
    local level with the condition that subrecipients commit to
    submitting data to the State in accordance with federal and State
    submission requirements.

-   Establishing or enhancing stand alone caches of ventilators, air way
    circuitry, IV pumps, monitors, pulse oximeters etc. available in
    each participating hospital to manage an initial influx of
    critically ill or injured patients. These caches must be clearly
    linked to HVAs and gap analyses that show where and why sufficient
    quantities do not currently exist.

-   Establishing or enhancing caches of specific categories of
    pharmaceuticals available on site in hospitals (i.e. broad spectrum
    and specific antibiotics,

> burn creams, pressors, analgesics and sedatives, H2 blockers,
> paralytics,
>
> induction agents, psychotropic medications etc.). These caches must be
> clearly linked to HVAs and gap analyses that show where and why
> sufficient quantities do not currently exist.
>
> **Training**
>
> FY 2006 training requirements will necessitate compliance with NIMS
> Integration Center (NIC) requirements as found on
> <http://www.fema.gov/txt/nims/TrainingGdlMatrix.txt>
>
> Awardees should work to document compliance with these requirements
> through a mechanism deemed efficient and practical.
>
> The Hospital Incident Command System (HICS) is currently undergoing
> significant updates and revisions and is due to be released in the
> Spring 2006; training efforts for 2006 should focus on incorporating
> both NIMS and HICS training elements into training plans.
>
> **Competency Based Training (required of all awardees) --** As in
> previous years all training that is supported through cooperative
> agreement dollars and delivered through the NBHPP must be competency
> based.
>
> Training is considered to be competency-based when:

-   Training is tied to/ determined by the desired competencies based
    upon expected functions during an emergency.

-   Targeted competencies are carefully selected based upon expected
    function during an emergency, matched to learner need and clearly
    communicated prior to the offering.

-   What constitutes "achievement" is clearly communicated and tied to
    actual performance.

-   The information/theory disseminated is directly and clearly linked
    to the competency addressed and available in a variety of formats.

-   Opportunities for practice are evident with the process, rationale,
    and benefits clearly presented to participants. Such practice
    opportunities match the specific competencies, context of training
    and anticipated outcomes.

-   Participative learning is evident.

-   Opportunities for the exchange of constructive feedback are evident
    in the course of the offering.

-   Delivery methods are appropriate given the targeted competencies,
    the characteristics of the participants and availability of
    equipment/resources.

> Examples of training activities that may be used and/or combined in
> competency based training include:

-   Oral presentations

-   Simulation activities

-   Project work

-   Group activities

-   Demonstrations

-   Shadowing/coaching

-   Distance/on line learning or other forms of asynchronous learning

-   Role plays

-   Practical placements

Awardees will:

-   Describe the capabilities and competencies that will be focused on
    with training dollars, the training and evaluation methodology to be
    used, and linkages with drills or exercises.

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-   Applicants should identify the number of personnel targeted for
    training by professional group and the estimated funding required
    for accomplishing these tasks.

-   Include in their application the name and contact information for
    the person "responsible" for overseeing training coordination and
    programming.

> **Exercises, Evaluations and Corrective Actions**
>
> **Terrorism Preparedness Exercises (required of all awardees) --**
> Hospitals as well as other healthcare entities must be full and
> present partners in planning, conducting, participating in and
> evaluating preparedness exercises and drills that occur at sub-State
> regional and State levels. After action reports must be reviewed for
> lessons learned and those lessens used to further enhance current
> facility based emergency operations plans and local emergency
> operations plans that have healthcare entities at the core.
>
> Awardees will discuss:

-   What sub-State regional drills and exercises are planned for the FY
    2006 budget cycle;

-   How many hospitals, rural health facilities, health centers, and
    other health care entities will participate;

-   What will the exercises and drill focus on (pandemic influenza,
    biologic agents, chemicals, explosive scenarios etc)

-   The role that healthcare facilities play in development,
    participation, evaluation and after action reports of these
    exercises; and

-   How the awardee will ensure that lessons learned from after action
    reports are shared back to the healthcare facilities and that the
    emergency operations plans of those facilities are then modified.

Additional activities for funding consideration under this capability
include:

-   Enhancement and upgrade of response plans based on AARs.

-   Release time for staff to attend drills and exercises. Salaries for
    back filling are not allowed costs under the cooperative agreement.

-   Development costs associated with exercises and drills.

**b) Methodology/ WORK PLAN**

Based on current system flexibilities, gaps that exist in any of the
Tiers and the capability elements, awardees will identify activities to
be addressed in FY 2006. Awardees will propose methods that will be used
to accomplish these activities, as well as the previously-described
program requirements and in this grant announcement.

Describe the steps that will be used to achieve each of the activities
proposed in the application. The applicant must also indicate the
specific methods to be used to evaluate progress in each area of
activity.

> Identify plans for utilization of advisory committees, special task
> forces or teams in the accomplishment of project objectives. Describe
> the composition of these groups and how they are related to the
> jurisdiction's overall homeland security advisory committee (e.g.
> committee that looks at all Federal grants- DOJ, HHS, DHS). Identify
> the key agencies and/or organizations that will contribute to or
> participate in the project. Describe the role of each collaborating
> agency, demonstrating consistency with the proposed project
> objectives.
>
> **Include a timeline that identifies each activity, responsible staff
> for the activity, deliverables and allocation of funds to the
> activity.**

[]{.mark}

**c) Resolution of Challenges**

Discuss challenges that are likely to be encountered in designing and
implementing the activities described in the work plan, and approaches
that will be used to resolve such challenges*.* How will awardees
leverage and coordinate with other homeland security activities
available in the State?

**d) Evaluation and Technical Support Capacity**

Describe evaluation activities to measure the progress of the
cooperative agreement at the State, sub-State regional and local level.
Awardees will address how healthcare evaluation activities will be
coordinated with other homeland security evaluation activities including
Target Capability Assessments and other public health evaluation
activities to provide a comprehensive integrated evaluation strategy
across the spectrum of response.

**e) Organizational Information**

Provide information on the applicant agency's current mission and
structure, scope of current activities, and an organizational chart, and
describe how these all contribute to the ability of the organization to
conduct the program requirements and meet program expectations. Awardees
should clearly articulate the coordination intersects with public health
and other homeland security offices and activities in the State.

**x. 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]{.underline}**. Be sure each attachment is clearly labeled.

**Attachment 1:** Copy of NIMS Certification Letter sent to Department
of Homeland Security.

**Attachment 2**: Statement of promoting and encouraging NIMS adoption
by Specific Agencies listed on page 12

**Attachment 3: Job Descriptions for Key Personnel**

Keep each to one page in length as much as is possible. Item 6 in the
Program Narrative section of the PHS 5161-1 Form provides some guidance
on items to include in a job description.

**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.

**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 the subcontractors and any deliverable.
Letters of agreements must be dated. Include a letter stating
application was developed in coordination with the state hospital
association or representative(s) of the healthcare community (see page
7).

**Attachment 6:** Evidence of Non Profit status and invention related
documents, if applicable.

**Attachment 7: Line Item Budget Narrative Justification**

**Attachment 8: Other Relevant Documents**

Include here any other documents that are relevant to the application,
including letters of support. Letters of support must be dated. 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.

**Attachment 9: Tables, charts, etc.**

Other significant documents to provide further information about the
proposal, not included elsewhere in the table of contents.

**3. SUBMISSION DATES AND TIME**

**Application Due Date**

The due date for applications under this cooperative agreement
announcement is **July 10, 2006 at 8:00 P.M. ET.** Applications will be
considered as meeting the deadline if they are E marked on or before the
due date. Please consult Appendix A, Section 3 for detailed instructions
on submission requirements.

The Chief Grants Management Officer (CGMO) or a higher level designee
may authorize an extension of published deadlines when justified by
circumstances such as acts of God (e.g. floods or hurricanes),
widespread disruptions of mail service, or other disruptions of
services, such as a prolonged blackout. The authorizing official will
determine the affected geographical area(s).

Applications must be submitted by 8:00 P.M. ET. **To ensure that you
have adequate time to follow procedures and successfully submit the
application, we recommend you register immediately in Grants.gov (see
Appendix B) and complete the forms as soon as possible, as this is a new
process and may take some time.**

**Please refer to the Appendix B for important specific information on
registering, and Appendix A, Section 3 for important information on
applying through Grants.gov.**

**LATE APPLICATIONS**

Applications which do not meet the criteria above are considered late
applications. The HRSA shall notify each late applicant that its
application will not be considered in the current competition.

**4. INTERGOVERNMENTAL REVIEW**

The NBHPP 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 SPOC 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 SPOC in response to Executive Order 12372 are due sixty
days after the application due date.

**5. FUNDING RESTRICTIONS**

Applicants responding to this announcement may request funding for a
project period of up to 1 year.

Funds under this announcement may not be used for the following
purposes:

-   New construction

-   To supplant existing preparedness resources

    **6. OTHER SUBMISSION REQUIREMENTS**

As stated in Section IV.I., 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 the Addendum to this
> guidance.
>
> **Formal submission of the electronic application:** Applications
> completed online are considered formally submitted when the
> Authorizing Official electronically submits the application to HRSA
> through Grants.gov. However, to complete the submission requirements,
> a hard-copy of the SF-424/5161 Face Sheet must be printed, signed, and
> submitted to the HRSA Grants Application Center. The SF-424/5161 must
> be printed from theGrants.gov.
>
> For an application submitted electronically, the signed SF-424/5161
> must be sent to the HRSA GRANTS APPLICATION CENTER at the following
> address and received by HRSA by no later than five days after the date
> of submission in Grants.gov:
>
> The HRSA Grants Application Center
>
> The Legin Group, Inc.
>
> Attn: *National Bioterrorism Hospital Preparedness Program*
>
> Program Announcement No. HRSA-06-067
>
> CFDA No. 93.*889*
>
> 901 Russell Avenue, Suite 450
>
> Gaithersburg, MD 20879
>
> Telephone: 877-477-2123
>
> Applications will be considered as having met the deadline if: (1) the
> application has been successfully transmitted electronically by your
> organization's Authorizing Official through Grants.gov on or before
> the deadline date and time, and (2) the signed SF-424/5161 Face Sheet
> is received by HRSA no later than five days after the date of
> submission in Grants.gov.
>
> It is incumbent on applicants to ensure that the Authorized Official
> is available to submit the application to HRSA by the application due
> date. We will [not]{.underline} accept submission or re-submission of
> incomplete, rejected or otherwise delayed applications after the
> deadline.
>
> Again, please understand that we will not consider additional
> information and/or materials submitted after your initial application.
> You must therefore ensure that all materials are submitted together.

**V. Application Review Information - Required**

**1. Review Criteria**

> Procedures for assessing the technical merit of cooperative agreement
> applications have been instituted to provide for an objective review
> of applications and to assist the applicant in understanding the
> standards against which each application will be judged. Critical
> indicators have been developed for each review criterion to assist the
> applicant in presenting pertinent information related to that
> criterion and to provide the reviewer with a standard for evaluation.
> Review criteria are outlined below with specific detail and scoring
> points.
>
> Review Criteria are used to review and rank applications. The NBHPP
> has 6 criteria:
>
> **1. NEED (10%)** - The extent to which the application describes the
> problem and associated contributing factors to the problem.
>
> **2. RESPONSE (25%)** - The extent to which the proposed project
> responds to the "Purpose" included in the program description. The
> clarity of the proposed goals and objectives and their relationship to
> the identified project. The extent to which the activities (scientific
> or other) described in the application are capable of addressing the
> problem and attaining the project objectives.
>
> **3. EVALUATIVE MEASURES (25%)** - The effectiveness of the methods
> proposed to monitor and evaluate the project results. Evaluative
> measures must be able to assess 1) to what extent the program
> objectives have been met and 2) to what extent these can be attributed
> to the project.
>
> **4. IMPACT (10%)** - The extent and effectiveness of plans for
> dissemination of project results and/or the extent to which project
> results may be national in scope and/or degree to which the project
> activities are replicable, and/or the sustainability of the program
> beyond the Federal Funding.
>
> **5. RESOURCES/CAPABILITIES (20%)** - The extent to which project
> personnel are qualified by training and/or experience to implement and
> carry out the projects. The capabilities of the applicant
> organization, and quality and availability of facilities and personnel
> to fulfill the needs and requirements of the proposed project.
>
> **6. SUPPORT REQUESTED (10%)** - The reasonableness of the proposed
> budget in relation to the objectives, the complexity of the
> activities, and the anticipated results.
>
> **2. Review and Selection Process**

Applications will be reviewed internally by primary and secondary
reviewers using an objective scoring process. Independent review will
not be necessary since these are formula grants.

[]{.mark}

**VI. Award Administration Information**

**1. Award Notices**

> Each applicant will receive written notification of the outcome of the
> objective review process, including a summary of the expert
> committee's assessment of the application's merits and weaknesses, and
> whether the application was selected for funding. Applicants who are
> selected for funding may be required to respond in a satisfactory
> manner to Conditions placed on their application before funding can
> proceed. Letters of notification do not provide authorization to begin
> performance.
>
> The Notice of Grant Award sets forth 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, 2006.

**2. Administrative and National Policy Requirements**

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

**PUBLIC POLICY ISSUANCE**

[]{.mark}

**HEALTHY PEOPLE 2010**

> **Healthy People 2010** is a national initiative led by HHS that sets
> priorities for all HRSA programs. The initiative has two major goals:
> (1) To increase the quality and years of a healthy life; and (2)
> Eliminate our country's health disparities. The program consists of 28
> focus areas and 467 objectives. HRSA has actively participated in the
> work groups of all the focus areas, and is committed to the
> achievement of the Healthy People 2010 goals.
>
> 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}
>
> **Smoke Free Environment**
>
> The Public Health Service strongly encourages all award recipients to
> provide a smoke-free workplace and to promote the non-use of all
> tobacco products. 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.

[]{.mark}

[]{.mark}

**3. Reporting**

The successful applicant under this guidance must:

a.  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.  Submit a quarterly electronic PSC-272 via the Payment Management
    System. The reports identify cash expenditures against the
    authorized funds for the grant. Failure to submit the report may
    result in the inability to access grant funds. 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.  Submit a Financial Status Report. A financial status report is
    required within 90 days of the end of each grant year. The report is
    an accounting of expenditures under the project that year. More
    specific information will be included in your award notice;

d.  Submit a Progress Report(s).

> **Semi-Annual Performance Report**
>
> Within 30 days following the end of six months from the award date, a
> semi-annual performance report shall be submitted. A standardized
> semi-annual report form will be sent to all successful applicants.
> Semi-Annual Reports should be e-mailed to Ms. Mickey Reynolds and the
> HRSA project officer.

**Final Report**

> Within 90 days following the end of the project period a final report
> will be due which shall contain information and data of interest to
> the NBHPP program, HHS, and other States. A standardized final report
> form will be sent to all successful applicants. Final Reports should
> be e-mailed to Ms. Mickey Reynolds or Ms. Shonda Kast and the HRSA
> project officer.

**4. 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. On a regularly scheduled basis,
HRSA grantees are required to participate in a 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 are expected to prepare an Action Plan that
identifies key actions to improve program performance as well as
addresses any identified program requirement issues. Performance reviews
also provide direct feedback to the agency about the impact of HRSA
policies on program implementation and performance within communities
and States.

For additional information on performance reviews, please visit:
<http://www.hrsa.gov/performancereview>.

**VII. Agency Contacts**

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

Neal Meyerson, MPA

HRSA Division of Grants Management Operations

Parklawn Building, Room 11A-16

Rockville, MD 20857

Phone: 301-443-5906

FAX: 301-443-6686

Email: <nmeyerson@hrsa.gov>

Additional information related to overall program issues by contacting:

Melissa Sanders

Branch Chief

National Bioterrorism Hospital Preparedness Program

Healthcare Systems Bureau, HRSA

Parklawn Bldg, Room 13-103

5600 Fishers Lane

Rockville, MD 20857

Telephone: 301/443-0924

Fax: 301/480-0334 (Attn: Melissa Sanders)

Email: <msanders@hrsa.gov>

**VIII. 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 of the
> SF-424/5161 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]{.underline}**.
> Keep the review criteria in mind when writing the application.
>
> **Start preparing the application early.** Allow plenty of time to
> gather required information from various sources.
>
> **Follow the instructions in this guidance carefully.** Place all
> information in the order requested in the guidance. If the information
> is not placed in the requested order, you may receive a lower score.
>
> **Be brief, concise, and clear.** Make your points understandable.
> Provide accurate and honest information, including candid accounts of
> problems and realistic plans to address them. If any required
> information or data is omitted, explain why. Make sure the information
> provided in each table, chart, attachment, etc., is consistent with
> the proposal narrative and information in other tables.
>
> **Be organized and logical.** Many applications fail to write
> successful applications because the reviewers cannot follow the
> thought process of the applicant or because parts of the application
> do not fit together.
>
> **Be careful in the use of appendices.** Do not use the appendices for
> information that is required in the body of the application. Be sure
> to cross-reference all tables and attachments located in the
> appendices to the appropriate text in the application.
>
> **Carefully proofread the application.** Misspellings and grammatical
> errors will impede reviewers in understanding the application. Be sure
> pages are numbered (including appendices) and that page limits are
> followed. Limit the use of abbreviations and acronyms, and define each
> one at its first use and periodically throughout application. Make
> sure you submit your application in final form, without markups.
>
> **Print out and carefully review an electronic application**. Before
> submitting electronically, print out the application before submitting
> it to ensure appropriate formatting and adherence to page limit
> requirements.
>
> **Ensure that all information is submitted at the same time.** We will
> not consider additional information and/or materials submitted after
> your initial submission, nor will we accept e-mailed applications or
> supplemental materials once your application has been accepted.

APPENDIX A: HRSA's Electronic Submission User Guide

User Guide Table of Contents

> 1\. INTRODUCTION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....48
>
> 1.1. DOCUMENT PURPOSE AND
> SCOPE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....48
>
> 1.2. DOCUMENT ORGANIZATION AND VERSION
> CONTROL\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...48
>
> 2\. NONCOMPETING CONTINUATION
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...48
>
> 2.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...48
>
> 2.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) (IF NOT ALREADY
> REGISTERED)...................................................................................................\...\...\...\...\...49
>
> 2.3. PROJECT DIRECTOR AND AUTHORIZING OFFICIAL NEED TO REGISTER WITH
> HRSA EHBS
>
> (IF NOT ALREADY REGISTERED)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....50
>
> 2.4. APPLY THROUGH [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....50
>
> 2.4.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...50
>
> 2.4.2 Download Application Package
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....51
>
> 2.4.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....51
>
> 2.4.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....51
>
> 2.4.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....51
>
> 2.5. VERIFY IN HRSA ELECTRONIC HANDBOOKS
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....52
>
> 2.5.1 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....52
>
> 2.5.2 Manage Access to Your Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....52
>
> 2.5.3 Check Validation
> Errors\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...53
>
> 2.5.4 Fix Errors and Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...53
>
> 2.5.5 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....53
>
> 2.6. SUBMIT SIGNED FACE
> PAGE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....53
>
> 3\. COMPETING
> APPLICATION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....53
>
> 3.1. PROCESS
> OVERVIEW\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....53
>
> 3.2. GRANTEE ORGANIZATION NEEDS TO REGISTER WITH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/) NOT ALREADY
> REGISTERED)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....54
>
> 3.3. APPLY THROUGH
> [[GRANTS.GOV]{.underline}](http://GRANTS.GOV/)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....54
>
> 3.3.1 Find Funding
> Opportunity\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...54
>
> 3.3.2 Download Application
> Package\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...55
>
> 3.3.3 Complete
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...55
>
> 3.3.4 Submit
> Application\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....55
>
> 3.3.5 Verify Status of Application
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....55
>
> 3.4. SUBMIT SIGNED FACE PAGE
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....56
>
> 4\. GENERAL INSTRUCTIONS FOR APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...56
>
> 4.1. NARRATIVE ATTACHMENT
> GUIDELINES\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...56
>
> 4.1.1
> Font\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....56
>
> 4.1.2 Paper Size and
> Margins\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...57
>
> 4.1.3
> Names\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...57
>
> 4.1.4 Section Headings
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....57
>
> 4.1.5 Page
> Numbering\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....57
>
> 4.1.6 Allowable Attachment or Document
> Types\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....57
>
> 4.2. APPLICATION CONTENT ORDER (TABLE OF
> CONTENTS)\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....57
>
> 4.3. PAGE
> LIMIT\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....58
>
> 5.0 CUSTOMER SUPPORT INFORMATION
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....58
>
> 5.1.1 Grants.gov Customer
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...58
>
> 5.1.2 HRSA Call
> Center\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...58
>
> 5.1.3 HRSA Program
> Support\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...58
>
> 6.0
> FAQs\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....59
>
> 6.1.
> SOFTWARE\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....59
>
> 6.1.1 What are the software requirements for using
> Grants.gov?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....59
>
> 6.1.2 Why can\'t I download PureEdge Viewer onto my
> machine?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....59
>
> 6.1.3 I have heard that Grants.gov is not Macintosh compatible. What
> do I do if I use only a
> Macintosh?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> \...\...\...\...\...\...\.....60
>
> 6.1.4 What are the software requirements for HRSA
> EHBs?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...60
>
> 6.1.5 What are the system requirements for using HRSA EHBs on a
> Macintosh computer?\...\...\...\...\...\...\...\...60
>
> 6.2. APPLICATION RECEIPT
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...60

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?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....60
>
> 6.2.2 When do I need to submit my application?
> \...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....60
>
> 6.2.3 What emails can I expect once I submit my application? Is email
> reliable? \...\...\...\...\...\...\...\...\...\...\...\...\...61
>
> 6.2.4 If a resubmission is required because of Grants.gov system
> problems, will these be
>
> Considered
> \"late\"?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...61
>
> 6.3. APPLICATION
> SUBMISSION\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....62

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

> objective
> review?\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....62
>
> 6.4 GRANT.GOV
> HELP\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....62

# 

# 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)

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

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

## 2.2 Grantee Organization Needs to Register with Grants.gov (if not already registered) -- See Appendix B {#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.

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

##  {#section-1 .unnumbered}

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

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

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

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

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

-   Authorizing Official (AO),

-   Business Official (BO), and

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

###  {#section-2 .unnumbered}

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

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

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

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

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

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

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

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

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

HRSA Grants Application Center

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

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

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

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

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

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

# 3. Competing Application

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

-   Register the organization with Central Contractor Registry (CCR)

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

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

-   Register an Authorized Organization Representative (AOR)

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

-   Register the username and password with Grants.gov

-   Get authorized as an AOR by your organization

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

HRSA Grants Application Center

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

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

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

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

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

# 4. General Instructions for Application Submission

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

-   

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

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

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

### 4.1.1 Font  {#font .unnumbered}

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

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

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

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

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

### 4.1.3 Names {#names .unnumbered}

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

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

Please put all section headings flush left in bold type.

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

**Electronic Submissions**

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

Do not number the standard OMB approved form pages.

**Paper Submissions (When allowed)**

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

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

**Electronic Submissions**

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

.DOC - Microsoft Word

.RTF - Rich Text Format

.TXT - Text

.WPD - Word Perfect Document

.PDF - Adobe Portable Document Format

.XLS - Microsoft Excel

.XFD -- PureEdge Form

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

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

HRSA uses two standard packages from Grants.gov.

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

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

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

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

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

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

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

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

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

# 5. Customer Support Information

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

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

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

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

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

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

Please visit HRSA EHBs for online help. Go to:

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

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

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

# 

# 6. FAQs

## 6.1 Software {#software .unnumbered}

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

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

**System Requirements:**

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

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

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

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

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

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

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

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

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

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

Grants.gov website states:

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

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

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

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

IE 6.0 and above is the recommended browser.

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

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

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

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

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

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

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

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

**Competing Submissions:**

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

**Noncompeting Submissions:**

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

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

**Competing Submissions:**

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

**Noncompeting Submissions:**

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

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

###  {#section-4 .unnumbered}

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

**Competing Submissions:**

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

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

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

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

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

**Noncompeting Submissions:**

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

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

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

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

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

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

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

**Competing Submissions:**

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

**Noncompeting Submissions:**

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

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

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

Follow the instructions provided in section4.2 to ensure that your
application is presented in the right order and is compliant with all
the requirements.

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

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

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

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

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

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

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

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

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

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

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

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

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

Step 1: Register your organization

Step 2: Register yourself as an Authorized Organization Representative

Step 3: Get authorized by your organization to submit grants

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

Follow this checklist to complete your registration---

1\. Register Your Organization

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

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

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

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

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

\- Obtain your username and password

\- Register your username and password with Grants.gov

3\. Get Yourself Authorized as an AOR

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

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

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

**REGISTER YOUR ORGANIZATION**

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

**Obtain your organization's DUNS number**

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

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

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

**Register your organization with CCR**

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

**2. Register with Grants.gov**

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

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

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

You have now completed the registration process for Grants.gov. If you
are applying for a [new or competing continuation]{.underline} you may
find the application package through Grants.gov FIND. If you are filling
out a [non-competing continuation]{.underline} application you must
obtain the announcement number through your program office, and enter
this announcement number in the search field to pull up the application
form and related program guidance. Download the required forms and enter
your current grant number in the

appropriate field to begin the non-competing continuation application
which you will then upload for electronic submittal through Grants.gov.
For continuation applications which require submittal of performance
measures electronically, instructions are provided in the program
guidance on how to enter the HRSA electronic handbooks to provide this
information.

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

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

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

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

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

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

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

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

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

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

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

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

The HRSA Grants Application Center

The Legin Group, Inc.

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

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

901 Russell Avenue, Suite 450

Gaithersburg, MD 20879

Telephone: 877-477-2123

**Formal Submission of the Electronic Application**

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

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

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

**Performance Measures for Competitive Applications**

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

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

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

> **Appendix C: Relationship of Federal Preparedness Grants to Target
> Capabilities**

  ------------------------------ ---------- ---------- ----------- ---------- --------- ---------- ------------- ---------- --------- ---------- ------------------ ----------- ----------- ------------
  **37 Target Capabilities and   **SHSP**   **UASI**   **LETPP**   **MMRS**   **CCP**   **EMPG**   **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Categories**                                                                                                                                                                              

  **Common Target Capabilities** ** **      ** **      ** **       ** **      ** **     ** **      ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **

  Planning                       **Y**      **Y**      **Y**       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       ** **       **Y**

  Community Preparedness and     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Participation                                                                                                                                                                             

  Communications                 **Y**      **Y**      **Y**       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       ** **       **Y**

  Risk Management                **Y**      **Y**      ** **       ** **      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **

  **Prevent Mission Area Target                                                                                                                                                              
  Capabilities**                                                                                                                                                                            

  Info Gathering and Recognition **Y**      **Y**      **Y**       **Y**      **\***    ** **      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  of Indicators and Warnings                                                                                                                                                                

  Law Enforcement Investigation  **Y**      **Y**      **Y**       ** **      **\***    ** **      **Y**         **Y**      ** **     **Y**      ** **              ** **       ** **       ** **
  and Operations                                                                                                                                                                            

  Intelligence Analysis and      **Y**      **Y**      **Y**       ** **      **\***    ** **      **Y**         **Y**      ** **     **Y**      ** **              ** **       ** **       ** **
  Production                                                                                                                                                                                

  CBRNE Detection                **Y**      **Y**      **Y**       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       **Y**       ** **

  Intelligence / Information     **Y**      **Y**      **Y**       ** **      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Sharing and Dissemination                                                                                                                                                                 

  **Protect Mission Area Target                                                                                                                                                              
  Capabilities**                                                                                                                                                                            

  Critical Infrastructure        **Y**      **Y**      **Y**       ** **      **\***    ** **      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Protection                                                                                                                                                                                

  Epidemiological Surveillance & **Y**      **Y**      ** **       **Y**      ** **     ** **      ** **         ** **      ** **     ** **      ** **              **Y**       **Y**       **Y**
  Investigation                                                                                                                                                                             

  Public Health Laboratory       **Y**      **Y**      ** **       **Y**      ** **     ** **      ** **         ** **      ** **     ** **      ** **              **Y**       **Y**       **Y**
  Testing                                                                                                                                                                                   

  Food and Agriculture Safety    **Y**      **Y**      ** **       ** **      **\***    **Y**      ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  and Defense                                                                                                                                                                               

  **Respond Mission Area Target                                                                                                                                                              
  Capabilities**                                                                                                                                                                            

  Onsite Incident Management     **Y**      **Y**      ** **       ** **      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       ** **       ** **

  Citizen Protection: Evacuation **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  and/or In-Place Protection                                                                                                                                                                

  Emergency Operations Center    **Y**      **Y**      ** **       ** **      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Management                                                                                                                                                                                

  Isolation and Quarantine       **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      ** **     **Y**      ** **              **Y**       ** **       **Y**

  Critical Resource Logistics    **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  and Distribution                                                                                                                                                                          

  Urban Search & Rescue          **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         ** **      ** **     **Y**      **Y**              ** **       ** **       ** **

  Volunteer Management and       **Y**      **Y**      ** **       ** **      **\***    **Y**      ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  Donations                                                                                                                                                                                 

  Emergency Public Information   **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       **Y**
  and Warning                                                                                                                                                                               

  Responder Safety and Health    **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       **Y**       **Y**

  Triage and Pre-Hospital        **Y**      **Y**      ** **       **Y**      **\***    ** **      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       **Y**       ** **
  Treatment                                                                                                                                                                                 

  Public Safety and Security     **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Response                                                                                                                                                                                  

  Medical Surge                  **Y**      **Y**      ** **       **Y**      **\***    ** **      ** **         ** **      ** **     ** **      ** **              **Y**       **Y**       ** **

  Animal Health Emergency        **Y**      **Y**      ** **       ** **      **\***    ** **      ** **         ** **      ** **     ** **      ** **              ** **       **Y**       ** **
  Support                                                                                                                                                                                   

  Medical Supplies Management    **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              **Y**       **Y**       ** **
  and Distribution                                                                                                                                                                          

  Environmental Health           **Y**      **Y**      ** **       **Y**      **\***    ** **      ** **         ** **      ** **     ** **      ** **              ** **       ** **       **Y**

  Mass Prophylaxis               **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              **Y**       **Y**       **Y**

  Explosive Device Response      **Y**      **Y**      ** **       ** **      **\***    ** **      **Y**         **Y**      ** **     **Y**      **Y**              ** **       ** **       ** **
  Operations                                                                                                                                                                                

  Mass Care                      **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **

  Firefighting                   **Y**      **Y**      ** **       **Y**      **\***    ** **      **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Operations/Support                                                                                                                                                                        

  Fatality Management            **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              **Y**       ** **       ** **

  WMD/Hazardous Materials        **Y**      **Y**      ** **       **Y**      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       **Y**       ** **
  Response and Decontamination                                                                                                                                                              

  **Recover Mission Area Target                                                                                                                                                              
  Capabilities**                                                                                                                                                                            

  Structural Damage and          **Y**      **Y**      ** **       ** **      **\***    ** **      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Mitigation Assessment                                                                                                                                                                     

  Economic & Community Recovery  **Y**      **Y**      ** **       ** **      **\***    **Y**      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **

  Restoration of Lifelines       **Y**      **Y**      ** **       ** **      **\***    ** **      **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  ------------------------------ ---------- ---------- ----------- ---------- --------- ---------- ------------- ---------- --------- ---------- ------------------ ----------- ----------- ------------

> **Appendix D: FY 2006 Federal Preparedness Programs Allowable Cost
> Matrix**

  -------------------------- ---------- ---------- ----------- ---------- --------- ------------ ------------- ---------- --------- ---------- ------------------ ----------- ----------- ------------
                             **HSGP**                                               **Other                                                                       **HHS**                 
                                                                                    G&T**                                                                                                 

  **Allowable Planning       **SHSP**   **UASI**   **LETPP**   **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Costs**                                                                                                                                                                                 

  Public Education &         **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      **Y**              ** **       ** **       **Y**
  Outreach                                                                                                                                                                                

  Develop and implement      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**
  homeland security support                                                                                                                                                               
  programs and adopt ongoing                                                                                                                                                              
  DHS National Initiatives                                                                                                                                                                

  Develop and enhance plans  **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      ** **     **Y**      ** **              **Y**       ** **       **Y**
  and protocols                                                                                                                                                                           

  Develop or conduct         **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      ** **     **Y**      **Y**              ** **       **Y**       **Y**
  assessments                                                                                                                                                                             

  Establish, enhance, or     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       **Y**
  evaluate Citizen Corps                                                                                                                                                                  
  related volunteer programs                                                                                                                                                              

  Hiring of full- or         **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      ** **     **Y**      ** **              **Y**       **Y**       **Y**
  part-time staff or                                                                                                                                                                      
  contract/consultants to                                                                                                                                                                 
  assist with planning                                                                                                                                                                    
  activities (not for the                                                                                                                                                                 
  purpose of hiring public                                                                                                                                                                
  safety personnel                                                                                                                                                                        
  fulfilling traditional                                                                                                                                                                  
  public safety duties)                                                                                                                                                                   

  Conferences to facilitate  **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       **Y**
  planning activities                                                                                                                                                                     

  Materials required to      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**
  conduct planning                                                                                                                                                                        
  activities                                                                                                                                                                              

  Travel/per diem related to **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              **Y**       **Y**       **Y**
  planning activities                                                                                                                                                                     

  Overtime and Backfill      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       ** **
  costs (IAW operational                                                                                                                                                                  
  Cost Guidance)                                                                                                                                                                          

  Other project areas with   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  prior approval from ODP                                                                                                                                                                 

  **Allowable Organizational **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Activities**                                                                                                                                                                            

  Overtime for information,  ** **      **Y**      **Y**       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  investigative, and                                                                                                                                                                      
  intelligence sharing                                                                                                                                                                    
  activities (up to 25                                                                                                                                                                    
  percent of the allocation)                                                                                                                                                              

  Reimbursement for select   ** **      **Y**      **Y**       ** **      ** **     ** **        **Y**         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  operational expenses                                                                                                                                                                    
  associated with increased                                                                                                                                                               
  security measures at                                                                                                                                                                    
  critical infrastructure                                                                                                                                                                 
  sites incurred during                                                                                                                                                                   
  periods of DHS-declared                                                                                                                                                                 
  Code Orange.                                                                                                                                                                            

  Hiring of full- part-time  ** **      ** **      ** **       ** **      **Y**     **Y**        ** **         ** **      ** **     ** **      **Y**              ** **       ** **       ** **
  staff or contractors for                                                                                                                                                                
  emergency management                                                                                                                                                                    
  activities.                                                                                                                                                                             

  Hiring of                  ** **      **Y**      **Y**       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  contractors/consultants                                                                                                                                                                 
  for participation in                                                                                                                                                                    
  information/intelligence                                                                                                                                                                
  analysis and sharing                                                                                                                                                                    
  groups or fusion center                                                                                                                                                                 
  activities (limited to 25                                                                                                                                                               
  percent of the allocation)                                                                                                                                                              

  **Allowable Equipment      **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Categories**                                                                                                                                                                            

  Personal Protective        **Y**      **Y**      **Y**       **Y**      ** **     ** **        **Y**         ** **      ** **     **Y**      **Y**              **Y**       ** **       **Y**
  Equipment                                                                                                                                                                               

  Explosive Device           **Y**      **Y**      **Y**       ** **      ** **     ** **        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Mitigation and Remediation                                                                                                                                                              
  Equipment                                                                                                                                                                               

  CBRNE Operational Search   **Y**      **Y**      **Y**       **Y**      ** **     ** **        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  and Rescue Equipment                                                                                                                                                                    

  Information Technology     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       ** **       **Y**

  Cyber Security Enhancement **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Equipment                                                                                                                                                                               

  Interoperable              **Y**      **Y**      **Y**       **Y**      ** **     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              **Y**       ** **       **Y**
  Communications Equipment                                                                                                                                                                

  Detection Equipment        **Y**      **Y**      ** **       **Y**      ** **     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       **Y**

  Decontamination Equipment  **Y**      **Y**      ** **       **Y**      ** **     ** **        **Y**         ** **      **Y**     **Y**      **Y**              **Y**       ** **       **Y**

  Medical Supplies and       **Y**      **Y**      ** **       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              **Y**       ** **       ** **
  Limited Pharmaceuticals                                                                                                                                                                 

  Power Equipment            **Y**      **Y**      **Y**       **Y**      **Y**     ** **        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **

  CBRNE Reference Materials  **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       **Y**       **Y**

  CBRNE Incident Response    **Y**      **Y**      **Y**       **Y**      ** **     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Vehicles                                                                                                                                                                                

  Terrorism Incident         **Y**      **Y**      **Y**       ** **      ** **     ** **        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Prevention Equipment                                                                                                                                                                    

  Physical Security          **Y**      **Y**      **Y**       ** **      ** **     **Y**        **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **
  Enhancement Equipment                                                                                                                                                                   

  Inspection and Screening   **Y**      **Y**      **Y**       **Y**      ** **     ** **        **Y**         **Y**      ** **     ** **      **Y**              ** **       ** **       ** **
  Systems                                                                                                                                                                                 

  Agriculture Terrorism      **Y**      **Y**      ** **       **Y**      ** **     ** **        ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **
  Prevention, Response and                                                                                                                                                                
  Mitigation Equipment                                                                                                                                                                    

  CBRNE Response Watercraft  **Y**      **Y**      **Y**       ** **      ** **     ** **        **Y**         **Y**      **Y**     **Y**      ** **              ** **       ** **       ** **

  CBRNE Aviation Equipment   **Y**      **Y**      ** **       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **

  CBRNE Logistical Support   **Y**      **Y**      **Y**       **Y**      ** **     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **
  Equipment                                                                                                                                                                               

  Intervention Equipment     **Y**      **Y**      **Y**       ** **      ** **     ** **        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       ** **

  Other Authorized Equipment **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       ** **       ** **

  **Allowable Training       **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Costs**                                                                                                                                                                                 

  Overtime and backfill for  **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **
  emergency preparedness and                                                                                                                                                              
  response personnel                                                                                                                                                                      
  attending ODP-sponsored                                                                                                                                                                 
  and approved training                                                                                                                                                                   
  classes                                                                                                                                                                                 

  Overtime and backfill      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **
  expenses for part-time and                                                                                                                                                              
  volunteer emergency                                                                                                                                                                     
  response personnel                                                                                                                                                                      
  participating in ODP                                                                                                                                                                    
  training.                                                                                                                                                                               

  Training workshops and     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              **Y**       **Y**       **Y**
  conferences                                                                                                                                                                             

  Full- or part-time staff   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         **Y**      **Y**     **Y**      **Y**              ** **       **Y**       **Y**
  or contractors/consultants                                                                                                                                                              

  Travel                     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              **Y**       **Y**       **Y**

  Supplies                   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       **Y**       **Y**

  Other items                **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **

  **Allowable Exercise       **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Related Costs**                                                                                                                                                                         

  Exercise planning workshop **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**

  Full- or part-time staff   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**
  or contractors/consultants                                                                                                                                                              

  Overtime and backfill      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       ** **
  costs including expenses                                                                                                                                                                
  for part-time and                                                                                                                                                                       
  volunteer emergency                                                                                                                                                                     
  response personnel                                                                                                                                                                      
  participating in ODP                                                                                                                                                                    
  exercises                                                                                                                                                                               

  Travel                     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**

  Supplies                   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       **Y**

  Other items                **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      ** **     **Y**      ** **              ** **       ** **       ** **

  **Allowable Management &   **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Administrative Costs**                                                                                                                                                                  

  Hiring of full- or         **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        ** **         ** **      ** **     **Y**      **Y**              ** **       ** **       **Y**
  part-time staff or                                                                                                                                                                      
  contractors/consultants to                                                                                                                                                              
  assist with the management                                                                                                                                                              
  of HSGP, implementation of                                                                                                                                                              
  State Homeland Security                                                                                                                                                                 
  Strategy, application                                                                                                                                                                   
  requirements, compliance                                                                                                                                                                
  with reporting and data                                                                                                                                                                 
  collection requirements.                                                                                                                                                                

  Development of operating   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       ** **
  plans for information                                                                                                                                                                   
  collection and processing                                                                                                                                                               
  necessary to respond to                                                                                                                                                                 
  DHS/ODP Data calls                                                                                                                                                                      

  Overtime and backfill      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        ** **         ** **      ** **     ** **      ** **              ** **       ** **       **Y**
  costs                                                                                                                                                                                   

  Travel                     **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       **Y**

  Meeting related expenses   **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      ** **              ** **       ** **       **Y**

  Authorized office          **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        **Y**         ** **      **Y**     **Y**      **Y**              ** **       ** **       ** **
  equipment                                                                                                                                                                               

  Recurring expenses such as **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        ** **         ** **      ** **     ** **      **Y**              ** **       ** **       **Y**
  those associated with cell                                                                                                                                                              
  phones and faxes during                                                                                                                                                                 
  the period of performance                                                                                                                                                               
  of the Grant Program                                                                                                                                                                    

  Leasing or renting of      **Y**      **Y**      **Y**       **Y**      **Y**     **Y**        ** **         ** **      ** **     ** **      **Y**              ** **       ** **       ** **
  space for newly hired                                                                                                                                                                   
  personnel during the                                                                                                                                                                    
  period of performance of                                                                                                                                                                
  the Grant Program                                                                                                                                                                       

                             ** **      ** **      ** **       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              ** **       ** **       ** **

  Costs outlined in the                                                                                                                                                                   
  following table are NOT                                                                                                                                                                 
  allowed unless designated                                                                                                                                                               
  by a \"\*\". Those                                                                                                                                                                      
  designated by a \"\*\" are                                                                                                                                                              
  only allowable in a                                                                                                                                                                     
  limited capacity. Check                                                                                                                                                                 
  the specific program                                                                                                                                                                    
  guidance for detailed                                                                                                                                                                   
  information.                                                                                                                                                                            

                             **HSGP**                                               **Other                                                                       **HHS**                 
                                                                                    Office of                                                                                             
                                                                                    Grants and                                                                                            
                                                                                    Training**                                                                                            

  **Unauthorized Program     **SHSP**   **UASI**   **LETP**    **MMRS**   **CCP**   **EMPG**     **Transit**   **Port**   **Bus**   **Rail**   **Firefighters**   **NBHPP**   **BTCDP**   **PHEPCA**
  Expenditures**                                                                                                                                                                          

  General use software,      ** **      ** **      ** **       ** **      ** **     ** **        **\***        **\***     ** **     ** **      **\***             **\***      **\***      ** **
  computers and related                                                                                                                                                                   
  equipment, vehicles,                                                                                                                                                                    
  licensing fees                                                                                                                                                                          

  Weapons and Ammunition     ** **      ** **      ** **       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **                                      

  Construction and           **\***     **\***     **\***      ** **      ** **     **\***       ** **         ** **      ** **     ** **      **\***             **\***      **\***      **\***
  Renovation\                                                                                                                                                                             
  (**ONLY limited**                                                                                                                                                                       
  renovation is allowable in                                                                                                                                                              
  highlighted programs)                                                                                                                                                                   

  Hiring of public safety    ** **      ** **      ** **       ** **      ** **     **\***       ** **         ** **      ** **     ** **      **\***             **\***      **\***      **\***
  personnel for the purpose                                                                                                                                                               
  of fulfilling traditional                                                                                                                                                               
  public safety duties                                                                                                                                                                    

  Activities unrelated to    ** **      ** **      ** **       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              **\***      **\***      ** **
  the completion and                                                                                                                                                                      
  implementation of HSGP                                                                                                                                                                  

  Other items not in         ** **      ** **      ** **       ** **      ** **     ** **        ** **         ** **      ** **     ** **      ** **              **\***      **\***      **\***
  accordance with the AEL or                                                                                                                                                              
  previously listed                                                                                                                                                                       
  allowable costs                                                                                                                                                                         
  -------------------------- ---------- ---------- ----------- ---------- --------- ------------ ------------- ---------- --------- ---------- ------------------ ----------- ----------- ------------

**Appendix E: National Incident Management System (NIMS)**

**Compliance Activities for**

**Hospitals (public and private)** [^2]

**Organizational Adoption**

[Element 1]{.underline}

Adopt NIMS at the organizational level for all departments and business
units, as well as promote and encourage NIMS adoption by associations,
utilities, partners and suppliers.

*Example of compliance:*

-   *The seventeen elements included in this document are addressed in
    the organization's emergency management program documentation.*

    **Command and Management**

    [Element 2]{.underline}

Incident Command System (ICS)

Manage all emergency incidents and preplanned (recurring/special events)
in accordance with ICS organizational structures, doctrine, and
procedures, as defined in NIMS. ICS implementation must include
consistent application of Incident Action Planning and Common
Communications Plans.

*Example of compliance:*

-   *The organization's Emergency Operations Plan explains the use of
    ICS, particularly incident action planning and a common
    communications plan.*

    [Element 3]{.underline}

    Multi-agency Coordination System

Coordinate and support emergency incident and event management through
the development and use of integrated multi-agency coordination systems.
That is, develop and coordinate connectivity capability with Hospital
EOC and local Incident Command Posts (ICPs), local 911 centers, local
Emergency Operations Centers (EOCs) and the state EOC as applicable.

*Example of compliance:*

-   *The organization's Emergency Operations Plan explains the
    management and coordination linkage between the organization's
    emergency operations center and other, similar, external
    centers(multi-agency coordination system entities)*

    [Element 4]{.underline}

Public Information System (PIS)

Implement processes and/or plans to communicate timely, accurate
information including through a Joint Information System and Joint
Information Center.

*Example of compliance:*

-   *The organization's Emergency Operations Plan explains the
    management and coordination of public information with health care
    partners and jurisdictional authorities, such as local public
    health, emergency management, and so on.*

    **Preparedness Planning**

    [Element 5]{.underline}

Health care organizations will track NIMS implementation on a yearly
basis as part of the organization's emergency management program.

*Example of compliance: NIMS organizational adoption, command and
management, preparedness/planning, preparedness/training,
preparedness/exercises, resource management, and communication and
information management activities will be tracked from year-to-year with
a goal of improving overall emergency management capability.*

[Element 6]{.underline}

Develop and implement a system to coordinate appropriate hospital
preparedness funding to employ NIMS across the organization.

*Example of compliance:*

-   *The organization's emergency management program documentation
    includes information on local, state and federal preparedness grants
    that have been received and work progress.*

    [Element 7]{.underline}

Revise and update plans and SOPs to incorporate NIMS components,
principles and policies, to include planning, training, response,
exercises, equipment, evaluation and corrective action.

*Example of compliance:*

-   *The organization's emergency management program work plan reflects
    status of any revisions to the Emergency Operations Plan, training
    materials, response procedures, exercise procedures, equipment
    changes and/or purchases, evaluation and corrective action
    processes.*

    [Element 8]{.underline}

Participate in and promote interagency mutual aid agreements, to include
agreements with the public and private sector and non-governmental
organizations.

*Example of compliance:*

-   *The organization's emergency management program documentation
    includes information on mutual aid agreements.*

    **Preparedness Training**

    [Element 9]{.underline}

    Complete IS-700: NIMS: An Introduction.

*Example of compliance:*

-   *The organization's emergency management program training records
    track completion of IS 700 or equivalent by personnel who are likely
    to assume an incident command position described in the hospital's
    emergency management plan.*

    [Element 10]{.underline}

    Complete IS-800: NRP: An Introduction.

*Example of compliance:*

-   *The organization's emergency preparedness program training records
    track completion of IS 800 or equivalent by individual(s)
    responsible for the hospital's emergency management program.*

    [Element 11]{.underline}

    Complete ICS 100 and ICS 200 training.

*Examples of compliance:*

-   *The organization's emergency preparedness program training records
    track completion of ICS 100 or equivalent by personnel who are
    likely to assume an incident command position described in the
    hospital's emergency management plan.*

-   *The organization's emergency management program training records
    track completion of ICS 200 or equivalent by personnel who are
    likely to assume an incident command position described in the
    hospital's emergency management plan.*

    **Preparedness Exercises**

    Element 12

Incorporate NIMS/ICS into internal and external, local and regional
emergency management training and exercises.

*Example of compliance:*

-   *The organization's emergency management program training and
    exercise documentation reflects use of NIMS/ICS.*

    [Element 13]{.underline}

Participate in an all-hazard exercise program based on NIMS that
involves responders from multiple disciplines, multiple agencies and
organizations.

*Example of compliance:*

-   *The organization's emergency management program training and
    exercise documentation reflects the organization's participation in
    exercises with various external entities.*

    [Element 14]{.underline}

Incorporate corrective actions into preparedness and response plans and
procedures.

*Example of compliance:*

-   *The organization's emergency management program documentation
    reflects a corrective action process.*

    **Resource Management**

    [Element 15]{.underline}

    Maintain an inventory of organizational response assets.

*Example of compliance:*

-   *The organization's emergency management program documentation
    includes a resource inventory (e.g. medical/surgical supplies,
    pharmaceuticals, personal protective equipment, staffing, etc.).*

    [Element 16]{.underline}

To the extent permissible by law, ensure that relevant national
standards and guidance to achieve equipment, communication, and data
interoperability are incorporated into acquisition programs.

*Example of compliance:*

-   *The organization's emergency management program documentation
    includes emphasis on the interoperability of response equipment,
    communications and data systems with external entities.*

    **Communications and Information Management**

    [Element 17]{.underline}

Apply standardized and consistent terminology, including the
establishment of plain English communications standards across the
public safety sector.

*Example of compliance:*

-   *The organization's emergency management program documentation
    reflects an emphasis on the use of plain English by staff during
    emergencies.*

> **Appendix F: Targeted Funding to Urban Areas and Associated Sub-State
> Regions**
>
> The following table delineates the major city in each State being
> targeted for additional funding allocations. Awardees are instructed
> that fund are to go to the city AND associated sub-State region
> (previously defined for the cooperative agreement) at a rate 10% above
> the FY 2005 funding level.
>
> \*States that have directly funded cities will fund the regions
> bordering the identified city as noted.

+---------+------------------------------------------------------------+
| **      | **City / Sub-State Region**                                |
| State** |                                                            |
+---------+------------------------------------------------------------+
| **AL**  | Birmingham                                                 |
+---------+------------------------------------------------------------+
| **AK**  | Anchorage                                                  |
+---------+------------------------------------------------------------+
| **AZ**  | Phoenix                                                    |
+---------+------------------------------------------------------------+
| **AR**  | Little Rock                                                |
+---------+------------------------------------------------------------+
| *       | **CA Regions I, II, V, VI bordering** **Los Angeles**      |
| *CA\*** |                                                            |
+---------+------------------------------------------------------------+
| **CO**  | Denver                                                     |
+---------+------------------------------------------------------------+
| **CT**  | Hartford                                                   |
+---------+------------------------------------------------------------+
| ** **   | New Haven                                                  |
+---------+------------------------------------------------------------+
| **DE**  | Dover                                                      |
+---------+------------------------------------------------------------+
| **DC**  | Washington, DC                                             |
+---------+------------------------------------------------------------+
| **FL**  | Miami                                                      |
+---------+------------------------------------------------------------+
| **GA**  | Atlanta                                                    |
+---------+------------------------------------------------------------+
| **HI**  | Honolulu                                                   |
+---------+------------------------------------------------------------+
| **ID**  | Boise                                                      |
+---------+------------------------------------------------------------+
| *       | **IL Regions 7, 8, 9, 10 bordering Chicago**               |
| *IL\*** |                                                            |
+---------+------------------------------------------------------------+
| **IN**  | Indianapolis                                               |
+---------+------------------------------------------------------------+
| **IA**  | Des Moines                                                 |
+---------+------------------------------------------------------------+
| **KS**  | Wichita                                                    |
+---------+------------------------------------------------------------+
| **KY**  | Louisville                                                 |
+---------+------------------------------------------------------------+
| **LA**  | Baton Rouge                                                |
+---------+------------------------------------------------------------+
| ** **   | New Orleans                                                |
+---------+------------------------------------------------------------+
| **ME**  | Portland                                                   |
+---------+------------------------------------------------------------+
| *       | **MD Region 5 bordering DC Metro Area \***                 |
| *MD\*** |                                                            |
+---------+------------------------------------------------------------+
| **MA**  | Boston                                                     |
+---------+------------------------------------------------------------+
| **MI**  | Detroit                                                    |
+---------+------------------------------------------------------------+
| **MN**  | Minneapolis/St Paul                                        |
+---------+------------------------------------------------------------+
| **MS**  | Jackson                                                    |
+---------+------------------------------------------------------------+
| **MO**  | St. Louis                                                  |
+---------+------------------------------------------------------------+
| **MT**  | Billings                                                   |
+---------+------------------------------------------------------------+
| **NE**  | Omaha                                                      |
+---------+------------------------------------------------------------+
| **NV**  | Las Vegas                                                  |
+---------+------------------------------------------------------------+
| **NH**  | Manchester                                                 |
+---------+------------------------------------------------------------+
| **NJ**  | Newark/Jersey City                                         |
+---------+------------------------------------------------------------+
| **NM**  | Albuquerque                                                |
+---------+------------------------------------------------------------+
| *       | **RRC Regions West Chester Medical Center, North Shore     |
| *NY\*** | University Hospital, University Hospital Stony Brook       |
|         | bordering**                                                |
|         |                                                            |
|         | **New York City \***                                       |
+---------+------------------------------------------------------------+
| **NC**  | Charlotte                                                  |
+---------+------------------------------------------------------------+
| **ND**  | Fargo                                                      |
+---------+------------------------------------------------------------+
| **OH**  | Cleveland                                                  |
+---------+------------------------------------------------------------+
| **OK**  | Oklahoma City                                              |
+---------+------------------------------------------------------------+
| **OR**  | Portland                                                   |
+---------+------------------------------------------------------------+
| **PA**  | Philadelphia                                               |
+---------+------------------------------------------------------------+
| **RI**  | Providence                                                 |
+---------+------------------------------------------------------------+
| **SC**  | Columbia                                                   |
+---------+------------------------------------------------------------+
| **SD**  | Sioux Falls                                                |
+---------+------------------------------------------------------------+
| **TN**  | Nashville                                                  |
+---------+------------------------------------------------------------+
| **TX**  | Houston                                                    |
+---------+------------------------------------------------------------+
| **UT**  | Salt Lake City                                             |
+---------+------------------------------------------------------------+
| **VT**  | Burlington                                                 |
+---------+------------------------------------------------------------+
| *       | **Northern Region bordering DC Metro Area \***             |
| *VA\*** |                                                            |
+---------+------------------------------------------------------------+
| **WA**  | Seattle                                                    |
+---------+------------------------------------------------------------+
| **WV**  | Charleston                                                 |
+---------+------------------------------------------------------------+
| **WI**  | Milwaukee                                                  |
+---------+------------------------------------------------------------+
| **WY**  | Cheyenne                                                   |
+---------+------------------------------------------------------------+

[^1]: The membership of the Senior Advisory Committee must, at a
    minimum, include State officials directly responsible for the
    administration of ODP grants and CDC and HRSA cooperative
    agreements: the State Administrative Agency (SAA), HRSA Program
    Director, HRSA Bioterrorism Hospital Coordinator, and CDC Program
    Director. In addition, program representatives from the following
    entities should be considered for membership on the committee: State
    Homeland Security Advisor (if this role is not also the SAA); State
    Emergency Management Agency Director; State Public Health Officer;
    State Public Safety Officer (and SAA for Justice Assistance Grants,
    if different); State EMS Director; State Trauma System Manager;
    State Citizen Corps POC; United States Coast Guard Area Command or
    Captain of the Port; Senior Members of the Regional Transportation
    Security Working Group, Senior Security Officials from Major
    Transportation Systems; and the Adjutant General.

[^2]: Draft developed for discussion by the HICS National Working Group
    and consideration by the NIMS Integration Center to address the
    question of "what types of activities should health care
    organizations engage in to ensure NIMS compliance?" The draft was
    developed from the NIMS National Standard Curriculum Training
    Development Guidance. Adaptations of the language for each element
    for health care organizations follows legislative format, with
    underlined items (additions) and strikethroughs (deletions).
    Examples of compliance were added to provide additional specificity
    to a health care organization.