[Federal Register Volume 65, Number 103 (Friday, May 26, 2000)]
[Notices]
[Pages 34189-34195]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-13243]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 00091]


State Cardiovascular Health Programs; Notice of Availability of 
Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2000 funds for a cooperative agreement 
program for State Cardiovascular Health Programs. CDC is committed to 
achieving the health promotion and disease prevention objectives of 
``Healthy People 2010,'' a national activity to reduce the morbidity 
and improve the quality of life. This program addresses the ``Healthy 
People 2010'' focus area of Heart Disease and Stroke. For the 
conference copy of ``Healthy People 2010'', visit the internet site: 
http://www.health.gov/healthypeople>.
    The purpose of the program is assist States in developing, 
implementing, and evaluating cardiovascular health promotion, disease 
prevention, and control programs. Also, to assist States in developing 
their Core Capacity Programs into Comprehensive Programs. Core Capacity 
Programs are the foundation upon which comprehensive cardiovascular 
health programs can be built.

Special Guidelines for Technical Assistance

Conference Call
    Technical assistance will be available for potential applicants on 
a conference call to be held from 2:00 EDT to 4:00 EDT on June 6, 2000. 
Potential applicant are requested to call in using only one telephone 
line. The conference can be accessed by calling 1-800-311-3437 [Federal 
call (404) 639-3277] and entering access code 371045. The purpose of 
the conference call is to help potential applicants to:

[[Page 34190]]

    1. Understand the scope and intent of the Program Announcement for 
the State Cardiovascular Health Programs;
    2. Be familiar with the Public Health Services funding policies and 
application and review procedures. Participation in this conference 
call is not mandatory. At the time of the call if you have problems 
accessing the call, contact 770-488-2525.

B. Eligible Applicants

    Assistance will be provided only to the health departments of 
States or their bona fide agents, except for the 11 States currently 
receiving funds under Program Announcement 98084, including the 
District of Columbia, the Commonwealth of Puerto Rico, the Virgin 
Islands, the Commonwealth of the Northern Mariana Islands, American 
Samoa, Guam, the Federated States of Micronesia, the Republic of the 
Marshall Islands, and the Republic of Palau.
    State health departments are uniquely qualified to define the 
cardiovascular disease problem throughout the State, to plan and 
develop statewide strategies to reduce the burden of cardiovascular 
diseases, to provide overall State coordination of cardiovascular 
health promotion, disease prevention, and control activities among 
partners, to lead and direct communities, to direct and oversee 
interventions within overarching State policies, and to monitor 
critical aspects of cardiovascular diseases.
    Eligible applicants may apply for either the Core Capacity Program 
or the Comprehensive Program. However, applicants choosing to apply for 
the Comprehensive Program must meet the matching requirement for State 
funds (see Recipient Financial Participation).
    To improve the cardiovascular health of all Americans, every State 
health department should have the capacity, commitment, and resources 
to carry out a comprehensive cardiovascular health promotion, disease 
prevention and control program. Applicants may apply for one, but not 
both, of the following levels of support:
    1. A Core Capacity Program to develop basic cardiovascular health 
promotion, disease prevention, and control functions and activities at 
the State level such as partnerships and program coordination related 
to primary and secondary prevention; scientific capacity; inventory of 
policy and environmental strategies; a State plan for cardiovascular 
health promotion, disease prevention, and control; training and 
technical assistance; culturally-competent strategies for addressing 
priority populations (See Attachment I); and population-based 
intervention strategies.
    2. A Comprehensive Program to continue and enhance core capacity 
functions, as needed, as well as implement, disseminate, and evaluate 
intervention activities throughout the State using State-level 
organizations, health care settings, work sites, schools, media, the 
government, and community-based organizations as primary modes of 
intervention for cardiovascular health promotion, disease prevention, 
and control; monitor secondary prevention strategies; and complement 
professional education activities. In addition to the components of the 
Core Capacity Programs, the Comprehensive Programs extend resources to 
local health agencies, communities, and organizations for 
implementation of cardiovascular health strategies.

C. Availability of Funds

    Approximately $4,950,000 is available in FY 2000 to fund 
approximately seven awards.
    1. Approximately $1,200,000 is available for approximately 3 to 5 
Core Capacity Program awards. It is expected that the average award 
will be $300,000, ranging from $250,000 to $450,000.
    2. Approximately $3,750,000 is available for approximately 2 to 4 
Comprehensive Program awards. It is expected that the average award 
will be $1,250,000, ranging from $1,000,000 to $1,400,000.
    It is expected that the awards will begin on or about September 30, 
2000 and will be made for a 12-month budget period within a project 
period of up to three years. Funding estimates may change.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.
    States that apply for Comprehensive Program funding should submit 
in their applications evidence that they have significant core capacity 
as specified in the Core Capacity Program Recipient Activities 1 
through 5.

Direct Assistance

    You may request Federal personnel as direct assistance in lieu of a 
portion of financial assistance.

Use of Funds

    Funds provided under this program announcement are not intended to 
be used to conduct community-based pilot or demonstration research 
projects. Cooperative agreement funds may be used to support personnel 
and to purchase equipment, supplies, and services directly related to 
program activities and consistent with the scope of the cooperative 
agreement. Cooperative agreement funds may not be used to supplant 
State or local funds, to provide inpatient care or personal health 
services, or support construction or renovation of facilities. 
Secondary prevention activities cannot provide for drugs, patient 
rehabilitation, or other costs associated with the treatment of 
cardiovascular diseases.

Recipient Financial Participation

    Under the Comprehensive Program of this announcement, matching 
funds are required from State sources in an amount not less than $1 for 
each $4 of Federal funds awarded. Applicants for the Comprehensive 
Program must provide evidence of State-appropriated resources targeting 
cardiovascular health promotion, disease prevention, and control of at 
least twenty percent of the total approved budget. The Preventive 
Health and Health Services (PHHS) Block Grant may not be included as 
State resources.
    Applicants may not use these funds to supplant funds from State 
sources or the Preventive Health and Health Services Block Grant 
dedicated to cardiovascular disease. Applicants must maintain current 
levels of support dedicated to cardiovascular disease from State 
sources or the Preventive Health and Health Services Block Grant.

Funding Preferences

    A preference will be given to those States in which mortality rates 
from ischemic heart disease or stroke exceed the national rates by ten 
percent or more. The States eligible for a preference (based on 
National Vital Records) that are not presently funded include: 
Arkansas, Indiana, Ohio, Oklahoma, Tennessee, and the District of 
Columbia.
    Other States or territories may request preference status; but, 
they must provide evidence that their mortality rate from ischemic 
heart disease exceeds 189.7/100,000 or the mortality rate from stroke 
exceeds 44.4/100,000. Mortality statistics provided by the applicant 
must use ICD-9 codes of 410-414 (Ischemic heart disease) and 430-438 
(Stroke), age-adjusted to the 1970 U.S. population, resident population 
only, for the 35-74 year-old population of the State, for 1991-1995 
based on National Vital Records available on CDC WONDER.

D. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient

[[Page 34191]]

will be responsible for conducting the activities under 1.a. (Recipient 
Activities for Core Capacity Programs) or under 1.b. (Recipient 
Activities for Comprehensive Programs), and CDC will be responsible for 
the activities listed under 2. (CDC Activities).

1.a. Recipient Activities for Core Capacity Programs

    (1) Develop and Coordinate Partnerships. Identify, consult with, 
and appropriately involve State cardiovascular health partners to 
identify areas critical to the development of a statewide 
cardiovascular health promotion, disease prevention, and control 
program, coordinate activities, avoid duplication of effort, and 
enhance the overall leadership of the State with its partners. Within 
the State health department, coordinate and collaborate with partners 
in nutrition, physical activity, tobacco, secondary prevention, 
diabetes, health education, Preventive Health and Health Services Block 
Grant, office of minority health, laboratory, as well as with data 
partners such as vital statistics and the State's Behavioral Risk 
Factor Surveillance System. Efforts to address tobacco use should be 
coordinated with the State tobacco program; tobacco-related activities 
should not be duplicated. Within State government, collaborate and 
partner with other departments such as education, transportation, parks 
and recreation and with State agency data partners, such as the youth 
risk behavioral surveillance system. Within the State, collaborate with 
other organizations such as the American Heart Association and other 
peer review organizations. Partnerships and collaborative efforts may 
develop into memorandums of agreement (MOA) or similar formalized 
arrangements. The State health department should organize a statewide 
work group or coalition with representation from other agencies, 
professional and voluntary groups, academia, community organizations, 
the media, and the public to develop a state plan.
    (2) Develop Scientific Capacity to Define the Cardiovascular 
Disease Problem. Enhance epidemiology, statistics, surveillance, and 
data analysis from existing data systems such as vital statistics, 
hospital discharges, and Behavioral Risk Factor Surveillance System 
(BRFSS). This should include the collecting of cardiovascular-related 
data using the BRFSS protocols and time line. It is suggested that 
funded States collect data on the BRFSS sections or modules on 
Hypertension Awareness, Cholesterol Awareness, and Cardiovascular 
Disease in odd years (i.e., 2001, 2003).
    It is suggested that funded States collect data using the Module on 
Heart Attack and Stroke Signs and Symptoms at least every four years 
(i.e., 2001, 2005) or, if possible, every two years (i.e., 2001, 2003, 
2005). The enhanced scientific capacity should include efforts to 
determine: (a) Trends in cardiovascular diseases, including age of 
onset of disease and age at death. (b) Geographic distribution of 
cardiovascular diseases.
    (c) The racial and ethnic disparities in cardiovascular diseases.
    (d) Ways to integrate systems to provide comprehensive data needed 
for assessing and monitoring the cardiovascular health of populations 
and program outcomes.
    Monitoring and program evaluation are considered essential 
components of building scientific capacity. Scientific capacity may 
also extend to developing access to outside databases such as medical 
care, and to laboratory development consistent with the overall 
direction of the program. State public health laboratories, or 
laboratories contracted by States to perform lipid and lipoprotein 
testing, should be standardized by the CDC Lipid Standardization 
Program.
    (3) Develop an Inventory of Policy and Environmental Strategies. 
Develop an inventory of policy and environmental issues in systems and 
settings (e.g., State-level, communities, health care sites, work 
sites, schools) affecting the cardiovascular health of the general 
population and priority populations. The inventory should focus on 
physical activity, nutrition, tobacco, elevated blood pressure, and 
elevated cholesterol. It should initially focus on state-level systems, 
and by funding future years it should include the remaining four 
settings (i.e., communities, health care sites, work sites, schools). 
Items inventoried could include issues related to food service 
policies; availability of environmental strategies for being active 
such as sidewalks, recreation centers, parks, walking trails; and 
restrictions on tobacco. Health care-related policy and environmental 
issues should relate to the standards of care for primary and secondary 
prevention and should be assessed in collaboration with purchasers of 
medical care, managed care organizations, and consumers. Attention 
should be paid to the needs of priority populations and the policy and 
environmental issues most vital to their cardiovascular health.
    (4) Develop or Update a State Plan. Develop or update a 
comprehensive State Plan for cardiovascular health promotion, disease 
prevention, and control to include specific objectives for future 
reductions in cardiovascular diseases and related risk factors. Develop 
a thorough description of the cardiovascular disease burden 
geographically and demographically, set objectives, and include 
population-specific strategies for achieving the objectives. The 
strategies should emphasize population-based policy and environmental 
approaches and education and awareness that increase support for policy 
and environmental approaches. It should also address the needs of 
priority populations. The strategies may also include planning for 
program development at the community level, particularly for priority 
populations. Partners should be involved in the development and 
implementation of the cardiovascular health State Plan.
    (5) Provide Training and Technical Assistance. Increase the skill-
level of State health department staff and partners in areas such as 
approaches to population-based interventions utilizing policy and 
environmental strategies; cardiovascular diseases and related risk 
factors including nutrition, physical activity, tobacco, elevated blood 
pressure, and elevated cholesterol; secondary prevention; social 
marketing and communications; epidemiology; cultural competency; use of 
data in program planning; and program planning and evaluation. Training 
may address State and local health department staff and partners, and 
may include provision of technical assistance to communities, work 
sites, health sites, schools, and faith-based organizations.
    (6) Develop Population-Based Strategies. Develop population-based 
intervention strategies to promote cardiovascular health, promote 
primary and secondary prevention of cardiovascular diseases and related 
risk factors (e.g., nutrition, physical activity, tobacco, elevated 
blood pressure, and elevated cholesterol); increase awareness of first 
signs and symptoms of heart attack and stroke, educate about the need 
for policy and environmental approaches, and reduce the burden of 
cardiovascular diseases in the State. The strategies may use State-
level organizations, health sites, work sites, schools, media, faith-
based organizations, community-based organizations, and governments as 
effective means to reach people.
    (7) Develop Culturally-Competent Strategies for Priority 
Populations. Develop strategies for enhanced program efforts to address 
priority

[[Page 34192]]

populations. Specify how interventions would be designed appropriately 
for the priority populations to be addressed. Strategies should focus 
on policy and environmental approaches specific for the population to 
be addressed but may, on a limited basis, include interventions such as 
community events, screenings, and campaigns designed to increase 
awareness of the cardiovascular disease burden and risk factors in the 
priority populations and to promote policy and environmental strategies 
to improve cardiovascular health and reduce risk factors. Initiatives 
may be used to demonstrate the effectiveness of selected strategies or 
as a means to generate community support for policy and environmental 
strategies.

1.b. Recipient Activities for Comprehensive Programs

    (1) Implement Population-Based Intervention Strategies Consistent 
with the State Plan. Strategies should include policy and environmental 
approaches, education and awareness supportive of the need for policy 
and environmental approaches, and other population-based approaches. 
These may be disseminated through various settings and groups including 
State-level organizations, health care settings, work sites, schools, 
community-based organizations, governments, and the media. 
Interventions should be population-based, with objectives established 
that specify the population-wide changes sought. Approaches should 
extend to a relatively large proportion of the population to be 
addressed, rather than a few selected communities. Interventions should 
be coordinated such that health messages, policies, and environmental 
measures are consistent, the most cost-effective methods are used for 
reaching the populations, and duplication of effort is avoided. 
Interventions should address physical activity, nutrition, tobacco, 
elevated blood pressure, elevated cholesterol and secondary prevention. 
Efforts to address tobacco use should be coordinated with the State 
tobacco program; tobacco-related activities should not be duplicated. 
Implementation may extend to grants and contracts with local health 
agencies, communities, and nonprofit organizations.
    (2) Implement Strategies Addressing Priority Populations. These 
strategies may include interventions directed to specific communities 
and segments of the population, and may include all appropriate modes 
of intervention needed to reach the populations to be addressed. These 
strategies may include more intensive, directed interventions by 
organizations concerned with improving the health and quality of life 
of priority populations, including community-based organizations, 
State-level organizations, faith-based organizations, work sites, 
health care sites, and schools.
    (3) Specify and Evaluate Intervention Components. Design and 
implement a program evaluation system. The evaluation plan should 
address measures considered critical to determine the success of the 
program. Evaluation should be limited in scope to address strategy 
implementation, changes in policies and the physical and social 
environments affecting cardiovascular health and, to a lesser degree, 
changes in behavioral risk factors. Evaluation should not include 
comparison communities or quasi-experimental designs. Evaluation should 
cover both population-based strategies as well as targeted strategies. 
Evaluation should rely primarily upon existing data systems such as 
vital statistics and hospital discharges.
    (4) Implement Professional Education Activities. Provide or 
collaborate with partners to provide professional education to health 
providers and others to assure appropriate primary and secondary 
prevention practices are offered routinely and to assure that 
appropriate standards of care are provided to all.
    (5) Monitor Secondary Prevention Strategies. Secondary prevention 
strategies may include such issues as aspirin and drug therapy, 
physical activity regimens, hormone replacement therapy, dietary 
changes, and hypertension and lipid management. Activities in secondary 
prevention should include monitoring the delivery of secondary 
prevention practices and collaborating with partners on professional 
education and policy change related to the implementation of the 
American Heart Association guidelines on primary and secondary 
prevention. Development of monitoring systems for secondary prevention 
practices may be coordinated with managed care providers, Medicaid, 
major employers, insurers, other organized health care providers, and 
purchasers of health care. Secondary prevention strategies may be 
integrated with professional education initiatives. Secondary 
prevention should not provide for drugs, patient rehabilitation, or 
other costs associated with the treatment of cardiovascular diseases.

2. CDC Activities

    a. Provide technical assistance in the coordination of surveillance 
and other data systems to measure and characterize the burden of 
cardiovascular diseases. Provide technical assistance in the design of 
surveillance instruments and sampling strategies, and provide 
assistance in the processing of data for States. Provide data on 
populations at highest risk. Provide data for national-level 
comparisons.
    b. Collaborate with the States and other appropriate partners to 
develop and disseminate programmatic guidance and other resources for 
specific interventions, media campaigns, and coordination of 
activities.
    c. Collaborate with the States and other appropriate partners to 
develop and disseminate recommendations for policy and environmental 
interventions including the measurement of progress in the 
implementation of such interventions.
    d. Collaborate with appropriate public, private, and nonprofit 
organizations to coordinate a cohesive national program.
    e. Provide technical assistance to the State public health 
laboratory or contract laboratory to standardize cholesterol, high 
density lipoproteins, and triglyceride measurements.
    f. Provide training and technical assistance regarding the 
coordination of interventions, policy and environmental strategies, and 
population-based strategies.
    g. If requested, provide Federal personnel in lieu of a portion of 
the financial assistance.

E. Application Content

    Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. Applications for the Core Capacity Program should not exceed 60 
double-spaced pages, printed on one-side, in 12 point font, excluding 
budget, justification, and appendixes. Applications for the 
Comprehensive Program should not exceed 130 double-spaced pages, 
printed on one-side, in 12 point font, excluding budget, justification, 
and appendixes. Applicants should also submit appendixes including 
resumes, job descriptions, organizational chart, facilities, and any 
other supporting documentation as appropriate. All materials must be 
suitable for photocopying (i.e., no audiovisual materials, posters, 
tapes, etc.)
    Applicants may apply for funding of either Core Capacity activities 
or Comprehensive activities, but not both, and must designate in the 
Executive

[[Page 34193]]

Summary of their application the component (Core Capacity Program or 
Comprehensive Program) for which they are applying. Provide the 
following information:

1. Executive Summary

    All applicants must provide a summary of the program described in 
the proposal (two pages maximum).

2. Core Capacity Program

a. Staffing (not included in 60-page limitation)
    Describe program staffing and qualifications including contacts for 
physical activity, nutrition, tobacco, secondary prevention, 
epidemiology, and evaluation. Provide organizational chart, resumes, 
job descriptions, and experience for all budgeted positions. Describe 
lines of communication between various related chronic disease 
programs.
b. Facilities (not included in 60-page limitation)
    Describe facilities and resources available to the program, 
including equipment available, communications systems, computer 
capabilities and access, and laboratory facilities if appropriate.
c. Background and Need
    Thoroughly describe the need for funding and the current resources 
available for Core Capacity activities, to include:
    (1) The overall State cardiovascular disease problem.
    (2) The geographic patterns, trends, age, gender, racial and ethnic 
patterns, and other measures or assessments.
    (3) The barriers the State currently faces in developing and 
implementing a statewide program for the prevention of cardiovascular 
diseases.
    (4) The advisory groups, partnerships, or coalitions currently 
involved with the State health department for cardiovascular disease 
prevention and control.
    (5) The current chronic disease programs within the State health 
department.
    (6) The gaps in resources, staffing, capabilities, and programs 
that, if addressed, might further the progress of cardiovascular 
disease prevention; and how the funds will be used to fill the gaps in 
the core capabilities of the State cardiovascular disease prevention 
and control efforts.
d. Core Capacity Work Plan
    Provide a work plan that addresses each of the required Core 
Capacity elements cited in the Recipient Activities section above, to 
include the following information:
    (1) Program objectives for each of the elements. Objectives should 
describe what is to happen, by when, and to what degree.
    (2) The proposed methods for achieving each of the objectives.
    (3) The proposed plan for evaluating progress toward attainment of 
the objectives.
    (4) A milestone, time line, and completion chart for all objectives 
for the project period.
e. Core Capacity Program Budget
    Provide a detailed line-item budget with justifications consistent 
with the purpose and proposed objectives, using the format on CDC Form 
0.1246. Applicants are encouraged to include budget items for travel 
for three trips to Atlanta, Georgia for three individuals to attend 
three-day training and technical assistance workshops.
    Supporting material such as organizational charts, tables, position 
descriptions, relevant publications, letters of support, memorandums of 
agreement, etc., should be included in the appendixes and be 
reproducible.

3. Comprehensive Program (Narrative portions of the Comprehensive 
Program application may not exceed 130 double-spaced pages using 12 
point font)

a. Background and Need
    (1) Provide evidence that the State health department has 
significant core capacity as specified in the Core Capacity Program 
Recipient Activities 1 through 5.
    (2) Provide a thorough description of the overall burden of 
Cardiovascular disease and related risk factors in the State and the 
need for support in the State; the geographic and demographic 
distribution, age, sex, racial and ethnic groups, educational, and 
economic patterns of the diseases as well as the trends over time. 
Describe the barriers to successful implementation of a statewide 
program for prevention of cardiovascular diseases within the State; 
partnerships and collaboration with related agencies, and the status of 
policies and environmental approaches in place that influence risk 
factors and public awareness. Describe how the funding will be used to 
fill the gaps in cardiovascular disease prevention activities. Provide 
a description of the populations to be addressed, including priority 
populations, and their constituencies and leadership potential to 
develop and conduct program activities.
b. Staffing (not included in 130-page limitation)
    Describe project staffing and qualifications including contacts for 
physical activity, nutrition, tobacco, secondary prevention, 
evaluation, and epidemiology. Provide organizational chart, curriculum 
vitae, job descriptions, and experience needed for all budgeted 
positions. Describe lines of communication between various related 
chronic disease programs.
c. State Plan
    Provide the current State plan (dated January 1997 or later) that 
includes population-based policy and environmental strategies as well 
as strategies for implementing programs which utilize health care 
settings, worksites, the media, schools, community-based organizations, 
the community at-large; and which includes strategies addressing 
specific priority populations and communities.
d. Evaluation
    Provide description of surveillance and monitoring activities that 
include mortality, changes in environmental and policy indicators, and 
behavioral risk factors including statistically valid estimates for 
populations to be addressed. Describe the capability for special one-
time surveys to be conducted by the state. Describe how each of the 
program elements will be evaluated and which measures are considered 
critical to monitor for evaluating the success of the program. Describe 
the various existing data systems to be employed, how the systems might 
be adapted, and the specific program elements to be evaluated by those 
systems. Describe the schedules for data collection and when analyses 
of the data will become available.
e. Comprehensive Program Work Plan
    Address each of the required Comprehensive Program recipient 
activities cited in the Recipient Activities section above in 
sufficient detail to describe the results expected and how the State 
will achieve the results. Objectives and strategies should specify 
priority populations to be addressed, communities, or geographic areas 
of concern; complete listings of the policy and environmental changes 
sought to create heart-healthy environments for the population; other 
intervention strategies; coordination among State partners; and 
strategies for closing the gap in cardiovascular disease disparity. 
Interventions should be expressed in terms of changes sought for the 
general population as well as

[[Page 34194]]

changes in Priority populations to be addressed. Population-based 
approaches should extend to a relatively large proportion of the State 
population rather than a few selected communities. Targeted strategies 
should clearly define the priority populations to be addressed. 
Objectives should describe what is to happen, by when, and to what 
degree. A milestone and activities completion chart or time line should 
be provided for all objectives for the project period.
f. Collaboration
    Provide letters of support describing the nature and extent of 
involvement by outside partners and coordination among State health 
department programs, other State agencies, and nongovernmental health 
and nonhealth organizations. Describe how the overall delivery of 
interventions for priority populations will be enhanced by these 
collaborative activities. Describe current data systems and how 
coordination will be ensured with managed care providers, Medicaid, 
major employers, insurers, and other organized health care providers, 
as well as purchasers of health care.
g. Training Capability
    Provide a description of training sessions for health professionals 
provided within the past three years. Include agendas, dates, 
professional status or occupation, and number of attendees. Provide 
other evidence of training capabilities deemed appropriate to the 
program.
h. Comprehensive Program Budget Justification
    Provide a line-item budget consistent with CDC Form.1246(E) along 
with appropriate justifications. Applicants are encouraged to include 
budget items for travel for three trips to Atlanta, Georgia for three 
individuals to attend three-day training and technical assistance 
workshops. State matching funds should be listed on question 15 
(estimated funding) of the application face page and Section C of the 
Budget Information worksheet.

F. Submission and Deadline

    Submit the original and two copies of new CDC Form 0.1246(E). Forms 
are available in the application kit. Submit the application, on or 
before July 14, 2000, to the Grants Management Specialist identified in 
Section J., ``Where to Obtain Additional Information''.
    Deadline: Applications shall be considered as meeting the deadline 
if they are either:
    (a) Received on or before the deadline date; or
    (b) Sent on or before the deadline date.
    (Applicants must request a legibly dated U.S. Postal Service 
postmark or obtain a legibly dated receipt from a commercial carrier or 
U.S. Postal Service. Private metered postmarks shall not be acceptable 
as proof of timely mailing.)
    Late Applications: Applications which do not meet the criteria in 
(a) or (b) above are considered late applications, will not be 
considered, and will be returned to the applicant.

G. Evaluation Criteria

    Each application will be evaluated individually against the 
following criteria by an independent review group appointed by CDC.

1. Core Capacity Program (Total 100 Points)

a. Staffing (10 Points)
    The degree to which the proposed staff have the relevant 
background, qualifications, and experience; and the degree to which the 
organizational structure supports staffs' ability to conduct proposed 
activities. The degree of coordination between relevant programs within 
the State health department.
b. Facilities (5 Points)
    The adequacy of the applicant's facilities and resources.
c. Background and Need (15 Points)
    The extent to which the applicant identifies specific needs and 
resources available for Core Capacity activities. The extent to which 
the funds will successfully fill the gaps in State capabilities. The 
extent to which the applicant demonstrates a review of journals and 
other publications particularly for policy and environmental 
strategies.
d. Core Capacity Work Plan (60 Points)
    (1) (20 Points) The extent to which the plan for achieving the 
proposed activities appears realistic and feasible and relates to the 
stated program requirements and purposes of this cooperative agreement.
    (2) (20 Points) The extent to which the proposed methods for 
achieving the activities appear realistic and feasible and relate to 
the stated program requirements and purposes of the cooperative 
agreement.
    (3) (10 Points) The extent to which the proposed plan for 
evaluating progress toward meeting objectives and assessing impact 
appears reasonable and feasible.
    (4) (10 Points) The degree to which partnerships are demonstrated 
through collaborative activities or letters of support.
e. Objectives (10 Points)
    The degree to which objectives are specific, time-phased, 
measurable, realistic, and related to identified needs, program 
requirements, and purpose of the program.
f. Budget (Not Scored)
    The extent to which the budget appears reasonable and consistent 
with the proposed activities and intent of the program.
    Content of Noncompeting Continuation Applications submitted within 
the project period need only include:
    1. A brief progress report that describes the accomplishments of 
the previous budget period.
    2. Any new or significantly revised items or information 
(objectives, scope of activities, operational methods, evaluation, key 
personnel, work plans, etc.) not included in year 01 or subsequent 
continuation applications.
    3. An annual budget and justification. Existing budget items that 
are unchanged from the previous budget period do not need re-
justification. Simply list the items in the budget and indicate that 
they are continuation items.
    However, States receiving Core Capacity Program funding may submit 
a competitive application for Comprehensive Program funding at the end 
of any budget period within the five-year project period, provided new 
funds are available to fund additional Comprehensive Programs. These 
applications must successfully address the application Evaluation 
Criteria for the Comprehensive Program; and, if successful, they will 
move from Core Capacity funding to Comprehensive funding. If 
unsuccessful, they will continue with Core Capacity funding.

2. Comprehensive Program (Total 100 Points):

a. Background and Need (30 Points)
    (1) (20 Points) The extent to which the applicant provides evidence 
that it has significant core capacity as specified in the Core Capacity 
Program Recipient Activities No.1 through No.5 (see Program 
Requirements section).
    (2) (10 Points) The extent to which the funds will fill the gaps in 
the State's cardiovascular disease prevention activities. The extent to 
which the applicant identifies specific needs in relation to geographic 
and demographic

[[Page 34195]]

distribution of cardiovascular diseases with particular emphasis on 
priority populations; identifies trends in mortality and risk factors; 
identifies barriers to successful program implementation; and describes 
existing policy and environmental influences in terms of their affect 
on public awareness and the risk factors for cardiovascular diseases.
b. Staffing (10 Points)
    The degree to which the proposed staff have the relevant 
background, qualifications, and experience; the degree to which the 
organizational structure supports staffs' ability to conduct proposed 
activities; the degree of staff coordination between relevant program 
within the State health department.
c. Comprehensive Work Plan (45 Points)
    (1)(20 Points) The extent to which the work plan for achieving the 
proposed activities appears realistic and feasible and relates to the 
stated program requirements and purposes of this cooperative agreement. 
The extent to which the plan addresses the needs of the State, the 
feasibility of the plan and the appropriateness of the planned 
interventions to the cardiovascular disease problem, and the adequacy 
of the plan to identify and address the needs of priority populations.
    (2) (20 Points) The extent to which the work plan addresses the 
problem through policy and environmental strategies and other 
appropriate population-based approaches and the extent of program 
activities that appropriately use settings (e.g., worksites, the media, 
schools, community-based organizations, faith-based organizations, the 
community at large).
    (3) (5 Points) The extent to which collaboration of State 
nutrition, physical activity, tobacco, health promotion, and other 
chronic disease programs with external partners is used to deliver the 
program; the extent to which coordination with other State chronic 
disease programs and other State agencies enhances the cardiovascular 
disease program; and the extent of involvement of community-based 
organizations in the implementation of the program.
d. Objectives (5 Points)
    The degree to which the objectives are specific, time-phased, 
measurable, realistic, and relate to identified needs and purposes of 
the program, for both the general population as well as the targeted 
populations.
e. Evaluation (10 Points)
    The extent to which the evaluation plan appears capable of 
monitoring progress toward meeting specific project objectives, 
assessing the impact of the program on the general population, 
assessing changes in the Priority populations, monitoring utilization 
of secondary prevention strategies, and assessing the implementation of 
policy and environmental strategies.
f. Budget (Not Scored)
    The extent to which the budget appears reasonable and consistent 
with the proposed activities and intent of the program. For the 
Comprehensive application, matching funds should be listed on question 
15 (estimated funding) of the application face page and section C of 
the Budget Information worksheet.

H. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of the following:
    1. Progress reports (semiannual);
    2. Financial status report, no more than 90 days after the end of 
the budget period; and
    3. Final financial and performance reports, no more than 90 days 
after the end of the project period. Send all reports to the Grants 
Management Specialist identified in the ``Where to Obtain Additional 
Information'' section of this announcement.
    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment II in the 
application kit.

AR-7  Executive Order 12372 Review
AR-10  Smoke-Free Workplace Requirements
AR-11  Healthy People 2010
AR-12  Lobbying Restrictions

I. Authority and Catalog of Federal Domestic Assistance Number 
(CFDA)

    This program is authorized under sections 301(a) and 317b(k)(2) of 
the Public Health Service (PHS) Act, [42 U.S.C. sections 241(a) and 
247b(k)(2)], as amended.
    The Catalog of Federal Domestic Assistance (CFDA) number is 93.945.

J. Where To Obtain Additional Information

    This and other CDC announcements can be found on the CDC home page 
at Internet address http://www.cdc.gov. Click on Funding then click on 
Grants and Cooperative Agreements.
    If you have questions after reviewing the contents of all 
documents, business management assistance may be obtained from: Van A. 
King, Grants Management Specialist, Grants Management Branch, 
Procurement and Grants Office, Announcement 00091, Centers for Disease 
Control and Prevention (CDC), 2920 Brandywine Road, Room 3000, Atlanta, 
GA 30341-4146, Telephone Number (770) 488-2751, Email address 
<a href="/cdn-cgi/l/email-protection#87f1e5ecb2c7e4e3e4a9e0e8f1"><span class="__cf_email__" data-cfemail="3543575e00755651561b525a43">[email protected]</span></a>.
    For program technical assistance, contact: Nancy B. Watkins, 
Division of Adult and Community Health National, Center for Chronic 
Disease Prevention and Health Promotion, Centers for Disease Control 
and Prevention, 4770 Buford Highway, MS K-47, Atlanta, Georgia 30341-
4146, Telephone Number (770) 488-8004, Email address <a href="/cdn-cgi/l/email-protection#117f706620517275723f767e67"><span class="__cf_email__" data-cfemail="36585741077655525518515940">[email protected]</span></a>.

    Dated: May 22, 2000.
John L. Williams,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention (CDC).
[FR Doc. 00-13243 Filed 5-25-00; 8:45 am]
BILLING CODE 4163-18-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>