March 2003 

FISCAL YEAR 2004 

TRIBAL MANAGEMENT 

GRANTS 

FOR 

American Indian and Alaska Native 

Tribes and Tribal Organizations 

CFDA Number 93.228 

APPLICATION DEADLINE: 

August 1, 2003 

Department of Health and Human Services

Public Health Service 

Indian Health Service
March 2003 

FISCAL YEAR 2004 

APPLICATION KIT INFORMATION 

Enclosed is an Indian Health Service (IHS) Tribal Management Grant (TMG) Application Kit 

(CFDA No: 93.228) and instructions for the completion of the application. Tribes and Tribal 

organizations that want to be considered for an IHS TMG for fiscal year (FY) 2004 must submit an 

application. This grant program is established under the authority of section 103 (b)(2) and (e) of the 

Indian Self-Determination and Education Assistance Act. P.L. 93-638, as amended. 

Please review the enclosed materials and follow the instructions provided to complete your grant 

application. Please be sure that your application complies with each requirement as applications that are 

incomplete or do not follow the instructions in the Application Kit will be considered not in compliance 

and may not be reviewed. 

Applications must be postmarked by August 1, 2003. Mail the original and two copies of the 

completed application including the forms in PHS 5161 (revised 7/00) and other required documentation 

to the Grants Management Branch, Division of Acquisitions and Grants Management, 801 Thompson 

Avenue, Rockville, MD 20852. 

Ms. Deanna Dick, Office of Management Support, IHS, telephone (301) 443-6290, may be 

contacted regarding Tribal Management Grant program information. Ms. Patricia Spotted Horse, Grants 

Management Specialist, Grants Management Branch, IHS, telephone (301) 443-5204, may be contacted 

regarding business questions or to obtain additional application kits. 

Thank you for your interest in the Tribal Management Grant Program. 

Department of Health and Human Services

Public Health Service 

Indian Health Service
TABLE OF CONTENTS

Announcement of Competitive Grant Applications 

General Program Purpose and Grant Program Authority 1 

Eligible Applicants 1 

Application Availability 1 

Application Receipt Deadline 1 

Estimated Funds Available 2 

Estimated Range of Awards 2 

Contacts for Assistance 2 

General Project Information 

Funding Priorities 2 

Required Documentation 3 

Eligible Project Types, Maximum Funding and Support 4 

Ineligible Project Activities 6 

Other Limitations 7 

Project Narrative Evaluation Criteria 

Introduction and Need for Assistance 7 

Project Objective(s), Approach, Benefits/Results 9 

Project Evaluation 10 

Organizational Capabilities and Qualifications 10 

Categorical Budget and Budget Justifications 11 

Multiyear Project Requirements 11 

Appendix Items 11 

Application Transmittal Instructions and Format Guidelines 12 

Other Grant Program Related Information 13 

Application Consideration 14 

Grant Program Administration 15 

Assurances 15 

Grant Reporting Requirements 16 

Appendix A - OMB Circular No. A-133, Audits of States, Local Governments, and Non-Profit 

Organizations 

Appendix B - 25 CFR, Part 900 

Appendix C - Application Forms and Instructions 

Standard Form 424, Application for Federal Assistance 

Standard Form 424A, Budget Information - Non-Construction Programs 

Standard Form 424B, Assurances - Non-Construction Programs 

Certifications 

PHS-5161 Checklist 

Disclosure of Lobbying Activities 

Appendix D – FY 2004 General Information Page, FY 2004 Application Checklist, & 

Application Receipt Record, IHS-815-1A (Rev. 4/97) 
FY 2004 Tribal Management Grant Program 1 

INDIAN HEALTH SERVICE (IHS) 

DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) 

Tribal Management Grant (TMG) Program of American Indian and Alaska Native Tribes 

and Tribal Organizations (CFDA No. 93.228) 

GENERAL PROGRAM PURPOSE AND GRANT PROGRAM AUTHORITY: To assist 

Tribes/Tribal organizations in assuming all or part of existing IHS programs, services, functions, 

and activities (PSFA) through a Title I contract and to assist established Title I contractors and 

Title V compactors to further develop and improve their management capability. In addition, 

TMGs are available to any Tribe/Tribal organization under the authority of Public Law (P.L.) 

93-638 section 103(e) for (1) obtaining technical assistance from providers designated by the 

Tribe/Tribal organization (including Tribes/Tribal organizations that operate mature contracts) 

for the purposes of program planning and evaluation, including the development of any 

management systems necessary for contract/compact management and the development of cost 

allocation plans for indirect cost rates; and (2) planning, designing, and evaluating Federal health 

programs serving the Tribe/Tribal organization, including Federal administrative functions. 

These grants are established under the authority of section 103(b)(2) and section 103(e) of the 

Indian Self-Determination and Education Assistance Act, P.L. 93-638, as amended. 

ELIGIBILE APPLICANTS: Any federally recognized Indian Tribe or Tribally sanctioned 

Tribal organization is eligible to apply for a grant. Eligible applicants include Tribal 

organizations that operate mature contracts that are designated by a Tribe to provide technical 

assistance and/or training. 

APPLICATION AVAILABLE: March 2003 

This application is also available online at: www.ihs.gov/NonMedicalPrograms/tmg/index.asp 

APPLICATION DEADLINE: Applications must be postmarked by Friday, August 1, 2003 

(anticipated start date of grants: January 1, 2004). 
FY 2004 Tribal Management Grant Program

 

2 

ESTIMATED FUNDS AVAILABLE: $2,306,000 

The estimated amount of funds available for approximately 20-25 new and continuation awards 

is based on the Administration’s request for the TMG Program for FY 2004. These grants may 

be used as matching shares for other Federal grant programs that develop Tribal capabilities to 

contract for the administration and operation of health programs. 

ESTIMATED RANGE OF AWARDS: $50,000-$300,000 (Please see Project Types and 

Funding Levels for more detailed information.) 

CONTACTS FOR ASSISTANCE: For TMG program information, contact Ms. Deanna J. 

Dick, Office of Management Support, Indian Health Service, 801 Thompson Avenue, Rockville, 

Maryland 20852, (301) 443-6290. For grant application and business management information, 

contact Ms. Patricia Spotted Horse, Grants Management Branch, Indian Health Service, 

801 Thompson Avenue, Rockville, Maryland 20852, (301) 443-5204. (The telephone numbers 

are not toll-free.) 

GENERAL PROGRAM INFORMATION

FUNDING PRIORITIES: The IHS has established the following funding priorities for TMG 

awards. The funding of approved Priority I applicants will occur before the funding of approved 

Priority II applicants. Priority II applicants will be funded before approved Priority III 

applicants. Funds will be distributed until depleted. 

•

•

PRIORITY I - Any Indian Tribe that has received Federal recognition (restored, 

unterminated, funded, or unfunded) within the past 5 years. 

PRIORITY II - All other eligible federally recognized Indian Tribes or Tribal 

organizations submitting a competing continuation application or a new application with 

the sole purpose of addressing audit material weaknesses identified in Attachment A 

(Summary of Findings and Recommendations) and other attachments, if any, of the 

transmittal letter received from the Office of the Inspector General, National External 
FY 2004 Tribal Management Grant Program 3 

Audit Review (NEAR) Center. Please identify, by underlining, the weakness to be 

addressed on Attachment A. 

•

•

•

PRIORITY III – All other eligible federally recognized Indian Tribes or Tribal 

organizations submitting a competing continuation application or a new application. 

REQUIRED DOCUMENTATION 

The following documentation is required (if applicable): 

Tribal Resolution - A resolution of the Indian Tribe served by the project must 

accompany the application submission. An Indian Tribe that is proposing a project 

affecting another Indian Tribe must include resolutions from all affected Tribes to be 

served. Applications by Tribal organizations will not require a specific Tribal resolution 

if the current Tribal resolution(s) under which they operate would encompass the 

proposed grant activities. Draft resolutions are acceptable in lieu of an official 

resolution. However, an official signed Tribal resolution must be received by the Grants 

Management Branch prior to beginning of the Objective Review (October 6-10, 2003). If 

an official signed resolution is not submitted by the date referenced, the application will 

be considered incomplete and will be returned without consideration. 

Documentation for Priority I Participation - A copy of the Federal Register Notice or 

letter from the Bureau of Indian Affairs verifying establishment of Federal Tribal status 

within the last 5 years. 

•

•

Documentation for Priority II Participation – A copy of the transmittal letter and 

Attachment A from the Office of the Inspector General, NEAR Center. See Funding 

Priorities for more information. 

Documentation of Consortium Participation - If an Indian Tribe, submitting an 

application, is a member of a consortium, the Tribe must: 

1) Identify the consortium. 

2) Indicate if the consortium intends to submit a TMG application. 

3) Demonstrate that the Tribe’s application does not duplicate or overlap any objectives 

of the consortium’s application. 
FY 2004 Tribal Management Grant Program

 

4 

If a consortium is submitting an application it must: 

1) Identify all the consortium member Tribes. 

2) Identify if any of the member Tribes intend to submit a TMG application of their 

own. 

3) Demonstrate that the consortium’s application does not duplicate or overlap any 

objectives of the other consortium members who may be submitting their own TMG 

application. 

ELIGIBLE PROJECT TYPES, MAXIMUM FUNDING AND SUPPORT 

Applications submitted must be for only one project type. The TMG Program consists of four 

types of projects: (1) feasibility studies, (2) planning, (3) evaluation studies, and (4) health 

management structure development or improvement. Applications that address more than one 

project type will be considered ineligible and will be returned to the applicant. Please refer to 

page 6 for further information regarding ineligible activities. The maximum funding level noted 

includes both direct and indirect costs. Application budgets which exceed the maximum funding 

level will not be reviewed. 

•

-

-

-

FEASIBILITY STUDY – (Maximum Funding/Support: $70,000/12 months) A study of a 

specific IHS program or segment of a program to determine if Tribal management of the 

program is possible. The study shall present necessary plans, approach, training, and 

resources required to assume Tribal management of the program. The study shall include the 

following four components: 

Health needs and health care services assessments that identify existing health care 

services and delivery system, program divisibility issues, health status indicators, unmet 

needs, volume projections, and demand analysis. 

Management analysis of existing management structures, proposed management 

structures, implementation plans and requirements, and personnel staffing requirements 

and recruitment barriers. 

Financial analysis of historical trends data, financial projections and new resource 

requirements for program management costs, and analysis of potential revenues from 

Federal/non-Federal sources. 
FY 2004 Tribal Management Grant Program 5 

-

•

Decision statement/report that incorporates findings, conclusions, and recommenations; 

the presentation of the study and recommendations to the governing body for Tribal 

determination regarding whether Tribal assumption of program(s) is desirable or 

warranted. 

PLANNING – (Maxmimum funding/support: $50,000/12 months) A collection of data to 

establish goals and performance measures for the operation of current health programs or 

anticipated PSFAs under a Title I contract. Planning will specify the design of health 

programs and the management systems (including appropriate policies and procedures) to 

accomplish the health priorities of the Tribe/Tribal organization. For example, planning 

could include the development of a Tribal Specific Health Plan or a Strategic Health Plan, 

etc. Please note: The Public Health Service urges applicants submitting strategic health 

plans to address specific objectives of Healthy People 2010. Such interested applicants may 

purchase a copy of Healthy People 2010 (Summary Report in print; Stock No. 017-001-

00547-9) or CD-ROM (Stock No. 107-001-00549-5) through the Superintendent of 

Documents, Government Printing Office, P.O. Box 371954, Pittsburg, Pennsylvania, 15250-

7945, or (202) 512-1800. You may access this information via the Internet at the following 

Web site: www.health.gov/healthypeople/publications/. 

•

•

EVALUATION STUDY – (Maximum funding/support: $50,000/12 months) A systematic 

collection, analysis, and interpretation of data for the purpose of determining the value of a 

program. The extent of the evaluation study could relate to the goals and objectives, policies 

and procedures, or programs regarding targeted groups. The evaluation study could also be 

used to determine the effectiveness and efficiency of a Tribal program operation (i.e. direct 

services, financial management, personnel, data collection and analysis, third-party billing, 

etc.) as well as determine the appropriateness of new components to a Tribal program 

operation that will assist Tribal efforts to improve the health care delivery systems. 

HEALTH MANAGEMENT STRUCTURE – (Average funding/support: $100,000/12 

months; maximum funding/support: $300,000/36 months) Implementation of systems to 
FY 2004 Tribal Management Grant Program

 

6 

manage or organize PSFAs. Management structures include health department 

organizations; health boards; and financial management systems, including systems for 

accounting, personnel, third-party billing, medical records, management information 

systems, etc. This includes the design, improvements, and correction of management 

systems that address weaknesses identified through quality control measures, internal control 

reviews, and audit report findings under Office of Management and Budget (OMB) Circular 

No. A-133 - Revised June 24, 1997, “Audits of States, Local Governments, and Non-Profit 

Organizations.” (See Appendix A, OMB Circular No. A-133 - Revised June 24, 1997, 

“Audits of States, Local Governments, and Non-Profit Organizations,” and Appendix B, 25 

CFR Part 900, “Indian Self-Determination and Education Assistance Act Amendments,” 

Subpart F - “Standards for Tribal or Tribal Organization Management Systems.”) 

INELIGIBLE PROJECT ACTIVITIES 

The TMGs may not be used to support recurring operational programs or to replace existing 

public and private resources. Note: The inclusion of the following projects or activities in an 

application will render the application ineligible and the application will be returned to the 

applicant: 

• Planning and negotiating activities associated with the intent of a Tribe to enter the IHS SelfGovernance Project. A separate grant program is administered by the IHS for this purpose. 

Prospective applicants interested in this program should contact Ms. Mary Trujillo, Office of 

Tribal Self-Governance, Indian Health Service, Reyes Building, 801 Thompson Avenue, 

Suite 240, Rockville, Maryland 20852, (301) 443-7821, and request information concerning 

the “Tribal Self-Governance Program Planning Cooperative Agreement Announcement” or 

the “Negotiation Cooperative Agreement Announcement.” 

• Projects related to water, sanitation, and waste management. 

• Projects that include long-term care or provision of direct services. 

• Projects that include tuition, fees, or stipends for certification or training of staff to provide 

direct services. 

• Projects that include design and planning of construction for facilities, including activities 

related to Program Justification Documents. 
FY 2004 Tribal Management Grant Program 7 

• Projects that propose more than one project type. For example, the inclusion of strategic 

planning (planning) and third-party billing (health management structure) in one project, or 

the inclusion of program evaluation (evaluation) and medical records update (health 

management structure) in another project. 

OTHER LIMITATIONS - A current TMG recipient cannot be awarded a new, renewal, or 

competing continuation grant for any of the following reasons: 

• The Tribal management grantee may not have two Tribal management grants funded 

concurrently; 

• the current project is not progressing in a satisfactory manner; or 

• the current project is not in compliance with program and financial reporting requirements. 

Delinquent Federal Debts - No award shall be made to an applicant who has an outstanding 

delinquent Federal debt until either: 

• The delinquent account is paid in full; or 

• a negotiated repayment schedule is established and at least one payment is received. 

PROJECT NARRATIVE/EVALUATION CRITERIA 

The instructions for preparing the application narrative also constitute the evaluation criteria for 

reviewing and scoring the application. Weights assigned to each section are noted in 

parentheses. 

INTRODUCATION AND NEED FOR ASSISTANCE (20 points) 

a. Describe the Tribe’s/Tribal organization’s current health operation. Include what programs 

and services are currently provided (i.e., federally funded, State funded, etc.), information 

regarding technologies currently used (i.e., hardware, software, services, etc.), and identify 

the source(s) of technical support for those technologies (i.e., Tribal staff, Area Office, 

vendor, etc.). Include information regarding whether the Tribe/Tribal organization has a 

health department and/or health board and how long it has been operating. 

b. Describe the population to be served by the proposed project. Include a description of the 

number of IHS eligible beneficiaries who currently use services. 
FY 2004 Tribal Management Grant Program

 

8 

c. Describe the geographic location of the proposed project including any geographic barriers to 

the health care users in the area to be served. 

d. Identify all previous TMGs received, dates of funding, and summary of project 

accomplishments. Include how previous TMG funds facilitated the progression of health 

development relative to the current proposed project. (Copies of reports will not be 

accepted.) 

e. Identify the eligible project type and priority group of the applicant. 

f. Explain the reason for your proposed project by identifying specific gaps or weaknesses in 

services or infrastructure that will be addressed by the proposed project. Explain how these 

gaps/weaknesses were discovered. If proposed project includes information technology (i.e., 

hardware, software, etc.), provide further information regarding measures taken or to be 

taken that ensure the proposed project will not create other gaps in services or infrastructure 

(i.e., IHS interface capability, Government Performance Reporting Act reporting 

requirements, contract reporting requirements, Information Technology (IT) compatibility, 

etc.). 

g. Describe the effect of the proposed project on current programs (i.e., federally funded, State 

funded, etc.) and, if applicable, on current equipment (i.e., hardware, software, services, etc.). 

Include the affect of the proposed project on planned/anticipated programs and/or equipment. 

h. Address how the proposed project relates to the purpose of the TMG Program by addressing 

the appropriate description that follows: 

• Identify if the Tribe/Tribal organization is a Title I contractor. Address if the selfdetermination contract is a master contract of several programs or if individual contracts 

are used for each program. Include information regarding whether or not the Tribe 

participates in a consortium contract (i.e., more than one Tribe participating in a 

contract). Address what programs are currently provided through those contracts and 

how the proposed project will enhance the organization’s capacity to manage the 

contracts currently in place. 

• Identify if the Tribe/Tribal organization is a Title V compactor. Address when the 

Tribe/Tribal organization entered into the compact and how the proposed project will 

further enhance the organization’s management capabilities. 
FY 2004 Tribal Management Grant Program 9 

• Identify if the Tribe/Tribal organization is not a Title I or Title V organization. Address 

how the proposed project will enhance the organization’s management capabilities, what 

programs and services the organization is currently seeking to contract, and an 

anticipated date for contract. 

PROJECT OBJECTIVE(S), APPROACH, AND RESULTS/BENEFITS (40 points) 

a. Describe the proposed project objective(s) in measurable and quantifiable terms. 

b. Address how the proposed project will result in change or improvement in management 

capabilities by identifying the expected benefits (i.e., operational improvements) of each 

proposed project objective. Also include information regarding expected outcomes (i.e., 

tangible products) of each proposed project objective. 

c. Address the extent to which the proposed project will build the local capacity to provide, 

improve, or expand services that address the need of the target population. 

d. Submit a workplan in the appendix which includes the following information: 

• Provide the action steps on a timeline for accomplishing the proposed project 

objective(s). 

• Identify who will perform the action steps. 

• Identify what tangible products will be produced during and at the end of the proposed 

project objective(s). 

• Identify who will supervise the action steps taken. 

• Identify who will accept work products at the end of the proposed project. 

• Include any training that will take place during the proposed project and who will be 

attending the training. 

• Include evaluation activities planned. 

e. If consultants or contractors will be used during the proposed project, please include the 

following information in their scope of work (or note if consultants/contractors will not be 

used): 

• Educational requirements 

• Desired qualifications and work experience 

• Expected work products to be delivered on a timeline 
FY 2004 Tribal Management Grant Program

 

10 

If a potential consultant/contractor has already been identified, please include a resume in the 

appendix. 

f. Describe what updates (i.e., revision of policies/procedures, upgrades, technical support, etc.) 

will be required for the continued success of the proposed project. Include when these 

updates will be necessary and where funds will come from to conduct the update and/or 

maintenance. 

PROJECT EVALUATION (15 points) 

a. Describe how the progress of the proposed project objective(s) will be tracked (i.e., status 

reports, meetings, etc.) 

b. Define what data will be collected to evaluate the sucess of the proposed project objective(s). 

c. Describe how and when the data will be collected for the proposed project objective(s). 

d. Explain how the data will be used to show (i.e., measure, etc.) the change brought about by 

the proposed project objective. 

e. Describe any future evaluation efforts for the proposed project that will be conducted after 

the expiration of the grant. 

ORGANIZATIONAL CAPABILITIES AND QUALIFICATIONS (15 points) 

a. Describe the organizational structure of the Tribe/Tribal organization beyond health care 

activities. 

b. If the Tribe/Tribal organization does not have an established management system currently in 

place that complies with 25 Code of Federal Regulations 900, Subpart F, “Standards for 

Tribal Management Systems” (see Appendix), provide information regarding plans to obtain 

management systems. (If management systems are already in place, simply note it.) 

c. Describe the ability of the organization to manage the proposed project. Include information 

regarding similarly sized projects in scope and financial assistance as well as other grants 

and projects successfully completed. 

d. Describe what equipment (i.e., fax machine, phone, computer, etc.) and facility space (i.e., 

office space) will be available for use during the proposed project. Include information 

about any equipment not currently available that will be purchased through the grant. 
FY 2004 Tribal Management Grant Program 11 

e. List key personnel who will work on the project. Include title used in the workplan. In the 

appendix, include position descriptions and resumes for all key personnel. Position 

descriptions should clearly describe each position and duties, indicating desired 

qualifications and experience requirements related to the proposed project. Resumes must 

indicate that the proposed staff member is qualified to carry out the proposed project 

activities. 

f. If the project requires additional personnel (i.e., IT support, etc.), address how the 

Tribe/Tribal organization will sustain the position(s) after the grant expires. (If there is no 

need for additional personnel, simply note it.) 

CATEGORICAL BUDGET AND BUDGET JUSTIFICATION (10 points) 

a. Provide a categorical budget for each of the 12-month budget periods requested. 

b. If indirect costs are claimed, indicate and apply the current negotiated rate to the budget. 

Include a copy of the rate agreement in the appendix. 

c. Provide a narrative justification explaining why each line item is necessary/relevant to the 

proposed project. Include sufficient cost and other details to facilitate the determination of 

cost allowability (i.e., equipment specifications, etc.). 

MULTIYEAR PROJECT REQUIREMENTS 

Projects requiring a second or third year must include a program narrative, categorical budget, 

and budget justification for each additional year of funding requested. 

APPENDIX ITEMS 

•

•

•

•

•

•

Workplan for proposed objectives 

Position descriptions for key staff 

Resumes of key staff that reflect current duties 

Consultant proposed scope of work (if applicable) 

Indirect Cost Agreement 

Organizational chart (optional) 
FY 2004 Tribal Management Grant Program

 

12 

APPLICATION TRANSMITTAL INSTRUCTIONS AND FORMAT GUIDELINES

The IHS is accepting only paper applications at this time. Include one original and two complete 

copies of the final proposal with all required signatures and documentation. Mark the original 

application with a cover sheet that states, "Original Grant Application." Mail or hand-deliver the 

application to the Division of Acquisition and Grants Management, Grants Management Branch, 

Indian Health Service, 801 Thompson Avenue, Rockville, Maryland 20852. Please note: all 

mailed applications must be postmarked by August 1, 2003. 

Hand Delivered Proposals - Hand delivered proposals will be accepted from 8:00 a.m. to 

5:00 p.m. Eastern Standard Time, Mondays through Fridays. They will not be accepted after 

5:00 p.m. on August 1. Applications will be considered to meet the deadline if they are received 

on or before the deadline, with hand-carried applications received by close of business 5:00 p.m. 

For mailed applications, a dated, legible receipt from a commercial carrier or the U.S. Postal 

Service will be accepted in lieu of a postmark. Private metered postmarks will not be accepted 

as proof of timely mailing. Late applications not accepted for processing will be returned to the 

applicant and will not be considered for funding. Receipt of applications will be acknowledged 

via the IHS-815-1A (Rev. 4/97) Application Receipt Record. 

GRANT APPLICATION FORMAT GUIDELINES 

All applications should: 

•

•

•

•

•

•

Be single-spaced 

Be typewritten 

Have consecutively numbered pages 

Use black type not smaller than 12 characters per one inch 

Have one-inch border margins 

Be printed on one side only of standard size 8-1/2” x 11” paper 

•

•

Not be tabbed, glued, or placed in a plastic holder 

Contain a narrative that does not exceed 14 typed pages that includes the following sections: 

(1) Introduction and Need for Assistance 

(2) Project Objective(s), Approach, and Results and Benefits 

(3) Project Evaluation 
FY 2004 Tribal Management Grant Program 13 

(4) Organizational Capabilities and Qualifications 

The 14-page narrative does not include the workplan, standard forms, Tribal resolution(s), table 

of contents, budget, budget justifications, multiyear narratives, and/or the appendix items. 

Include in the application the following documents in the order presented: 

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

•

Application Receipt Record, IHS-815-1A (Rev. 4/97) 

FY 2004 TMG Application Checklist 

FY 2004 General Information Page 

Tribal Resolution (final signed or draft unsigned) 

Documentation for Priority I Participation (if applicable) 

Documentation for Priority II Participation (if applicable) 

Documentation of Consortium Participation (if applicable) 

Standard Form 424, Application for Federal Assistance 

Standard Form 424A, Budget Information - Non-Construction Programs (pages 1-2) 

Standard Form 424B, Assurances - Non-Construction Programs (front and back) 

Certifications (pages 17-19) 

PHS-5161 Checklist (pages 25-26) 

Disclosure of Lobbying Activities 

Table of contents with corresponding numbered pages 

Project narrative (not to exceed 14 typewritten pages) 

Categorical Budget and Budget Justification 

Multiyear narratives with corresponding Categorical Budget and Budget Justifications (if 

applicable) 

Appendix Items 

OTHER GRANT PROGRAM RELATED INFORMATION

There will be only one funding cycle in FY 2004. Executive Order 12372 requiring 

intergovernmental review is not applicable to this program. 
FY 2004 Tribal Management Grant Program

 

14 

APPLICATION CONSIDERATION 

In addition to the above critiera/requirements, applications are considered according to the 

following: 

1. Application Submission (Application deadline: August 1, 2003) 

Applications submitted by the deadline and verified by the postmark will undergo a review to 

determine that: 

• The applicant and proposed project type is eligible in accordance with this grant 

announcement. 

• The application is not a duplication of a previously funded project. 

• The application narrative, forms, and materials submitted meet the requirements of the 

announcement allowing the review panel to undertake an indepth evaluation; otherwise, 

it may be returned. 

2. Competitive Review of Eligible Applications (Objective Review: October 6-10, 2003) 

Applications meeting eligibility requirements that are complete, responsive, and conform to 

this program announcement will be reviewed for merit by the Ad Hoc Objective Review 

Committee (ORC) appointed by the IHS to review and make recommendations on these 

applications. The review will be conducted in accordance with the IHS Objective Review 

Guidelines. The technical review process ensures selection of quality projects in a national 

competition for limited funding. Applications will be evaluated and rated on the basis of the 

evaluation criteria listed above. The criteria are used to evaluate the quality of a proposed 

project, to determine the likelihood of success, and to assign a numerical score to each 

application. The scoring of approved applications will assist the IHS in determining which 

proposals will be funded if the amount of TMG funding is not sufficient to support all 

approved applications. Applications scoring below 60 points will be disapproved and 

returned to the applicant. 

3. Results of the Review (Notification: first week of December 2003) 

Applications recommended for approval, having a score of 60 or above, by the ORC are 

forwarded by the Grants Management Branch to the Area Offices for cost analysis and 

further recommendation. The program official accepts the Area Office Contract Proposal 

Liaison Officers’ recommendations for consideration when funding applications. The 

program official forwards the final approved list to the Director, Office of Management 
FY 2004 Tribal Management Grant Program 15 

Support, for final review and approval. The Director, Office of Management Support, or 

program official, will notify the contact person named on each proposal of all results in 

writing. Applicants will receive a copy of the Executive Summary, which identifies the 

weaknesses and strengths of the application submitted. Successful applicants will be notified 

through the official Notice of Grant Award (NGA) document. The NGA will state the 

amount of Federal funds awarded, the purpose of the grant, the terms and conditions of the 

grant award, the effective date of the award, the project period, and the budget period. 

GRANT ADMINISTRATION REQUIREMENTS 

Grants are administered in accordance with the following documents: 

1. This grant announcement 

2. Health and Human Services regulations governing P.L. 93-638 grants at 42 CFR 36.101 et 

seq. 

3. 45 CFR part 92, “Department of Health and Human Services, Uniform Administrative 

Requirements for Grants and Cooperative Agreements to State and Local Governments 

Including Indian Tribes,” or 45 CFR part 74, “Administration of Grants to Non-Profit 

Recipients” 

4. Public Health Service Grants Policy Statement 

5. Appropriate Cost Principles: OMB Circular A-87, “State and Local Governments,” or OMB 

Circular A-122, “Non-profit Organizations” 

6. OMB Circular A-133, “Audits of States, Local Governments, and Non-Profit Organizations” 

7. Applicable OMB Circulars. 

ASSURANCES 

The application shall contain assurances to the Secretary that the applicant will comply with 

program regulations, 42 CFR part 36 Subpart H. Standard Form 424B is in part 2 of the 

application kit. 
FY 2004 Tribal Management Grant Program

 

16 

GRANT REPORTING REQUIREMENTS 

1. Progress Report - Program progress reports are required semi-annually. These reports will 

include a brief comparison of actual accomplishments to the goals established for the period, 

reasons for slippage (if applicable), and other pertinent information as required. A final 

report must be submitted within 90 days of expiration of the budget/project period. 

2. Financial Status Report - Semi-annual financial status reports must be submitted within 30 

days of the end of the half-year. Final financial status reports are due within 90 days of 

expiration of the budget/project period. Standard Form 269 (long form) will be used for 

financial reporting.