6536 Federal Register / Vol. 62, No. 29 / Wednesday, February 12, 1997 / Notices

entrance between 20th and 2lst Streets,

N.W., Washington, D.C. 20551.

STATUS: Closed.

MATTERS TO BE CONSIDERED:

1. Personnel actions (appointments,

promotions, assignments,

reassignments, and salary actions)

involving individual Federal Reserve

System employees.

2. Any items carried forward from a

previously announced meeting.

CONTACT PERSON FOR MORE INFORMATION:

Mr. Joseph R. Coyne, Assistant to the

Board; (202) 452–3204. You may call

(202) 452–3207, beginning at

approximately 5 p.m. two business days

before this meeting, for a recorded

announcement of bank and bank

holding company applications

scheduled for the meeting.

Dated: February 10, 1997.

Jennifer J. Johnson,

Deputy Secretary of the Board.

[FR Doc. 97–3587 Filed 2–10–97; 10:17 am]

BILLING CODE 6210–01–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Office of the Secretary, Office of

Minority Health; Availability of Funds

for Grants for the Bilingual/Bicultural

Service Demonstration Program

(Managed Care)

AGENCY: Office of the Secretary.

ACTION: Notice of availability of funds

and request for applications.

AUTHORITY: This program is authorized

under section 1707(d)(1) of the Public

Health Service Act, as amended in

Public Law 101–527, the Disadvantaged

Minority Health Improvement Act of

1990.

PURPOSE: The purpose of this Fiscal

Year 1997 Bilingual/Bicultural Service

Demonstration Grant Program (Managed

Care) is to:

(1) provide support to improve and

expand the capacity and ability of

health care providers and other health

care professionals to deliver

linguistically and culturally competent

health services to limited-Englishproficient populations; and

(2) increase the limited-Englishproficient populations’ knowledge and

understanding about managed care and

its implications, including the different

managed care models/plans that exist,

so they can make informed decisions

about their health care.

These grants are intended to

demonstrate the merit of programs that

involve partnerships between minority

community-based organizations and

health care facilities in a collaborative

effort to address cultural and linguistic

barriers to effective health care service

delivery and to increase access to

effective health care for the limitedEnglish-proficient populations living in

the United States.

The Public Health Service (PHS) is

committed to achieving the health

promotion and disease prevention

objectives of Healthy People 2000, a

PHS-led national activity to reduce

morbidity and mortality and to improve

the quality of life. Potential applicants

may obtain a copy of Healthy People

2000 (Full Report: Stock No. 017–001–

00474–0) or Healthy People 2000:

Midcourse Review and 1995 Revisions

(Stock No. 017–001–00526–6) through

the Superintendent of Documents,

Government Printing Office,

Washington, D.C. 20402–9325 or

telephone (202) 783–8238.

ELIGIBLE APPLICANTS: Public and private,

nonprofit minority community-based

organizations which have an established

linkage with a health care facility

serving a targeted minority community

with limited-English-proficient

populations. Applicants must be located

within one of the following top 15

Metropolitan Statistical Areas identified

from the 1990 U.S. Census as having the

highest number of limited-Englishproficient households experiencing

linguistic isolation:

• Phoenix, AZ.

• Fresno, CA.

• Los Angeles/Anaheim/Riverside,

CA.

• Sacramento, CA.

• Honolulu, HI.

• Boston/Lawrence/Salem, MA–NH.

• Detroit/Ann Arbor, MI.

• New York/North New Jersey/Long

Island, NY–NJ–CT.

• Philadelphia/Wilmington/Trenton,

PA–NJ–DE–MD.

• Dallas/Ft. Worth, TX.

• El Paso, TX.

• Houston/Galveston/Brazoria, TX.

• McAllen/Edinburg/Mission, TX.

• Seattle/Tacoma, WA.

• Washington, DC Metropolitan

Statistical Area.

National organizations are not eligible

to apply; however, local affiliates of

national organizations which have an

established link with a health care

facility are eligible to apply. Currently

funded OMH Bilingual/Bicultural

Service Demonstration Program grantees

are not eligible to apply.

DEADLINE: To receive consideration,

grant applications must be received by

the OMH Grants Management Office by

April 11, 1997. Applications will be

considered as meeting the deadline if

they are: (1) received on or before the

established deadline date and received

in time for orderly processing.

Applicants should request a legibly

dated U.S. Postal Service postmark or

obtain a legibly dated receipt from a

commercial carrier or the U.S. Postal

Service. Private metered postmarks shall

not be acceptable as proof of timely

mailing. Applications submitted by

facsimile transmission (FAX) or any

other electronic format will not be

accepted. Applications which do not

meet the deadline will be considered

late and will be returned to the

applicant unread.

ADDRESSES/CONTACTS: Applications

must be prepared using Form PHS

5161–1 (Revised July 1992 and

approved by OMB under control

Number 0937–0189). Application kits

and technical assistance on budget and

business aspects of the application may

be obtained from Ms. Carolyn A.

Williams, Grants Management Officer,

Division of Management Operations,

Office of Minority Health, Rockwall II

Building, Suite 1000, 5515 Security

Lane, Rockville, MD 20852, telephone

(301) 594–0758. Completed applications

are to be submitted to the same address.

Questions regarding programmatic

information and/or requests for

technical assistance in the preparation

of grant applications should be directed

to Ms. Cynthia Amis, Director, Division

of Program Operations, Office of

Minority Health, Rockwall II Building,

Suite 1000, 5515 Security Lane,

Rockville, Maryland 20852, telephone

number (301) 594–0769.

The OMH Regional Minority Health

Consultants (RMHCs) are also available

to provide technical assistance. A listing

of the RMHCs and how they may be

contacted will be provided in the grant

application kit. Applicants can contact

the OMH Resource Center (OMH–RC) at

1–800–444–6472 for health information.

AVAILABILITY OF FUNDS: Approximately

$1.17 million is available for award in

FY 1997. It is projected that awards of

up to $100,000 total costs (direct and

indirect) for a 12-month period will be

made to approximately 10 to 12

competing applicants.

PERIOD OF SUPPORT: The start date for

the Bilingual/Bicultural Service

Demonstration Program (Managed Care)

grants is September 30, 1997. Support

may be requested for a total project

period not to exceed 3 years.

Noncompeting continuation awards of

up to $100,000 will be made subject to

satisfactory performance and

availability of funds.

BACKGROUND: Large numbers of

minorities in the United States are
Federal Register / Vol. 62, No. 29 / Wednesday, February 12, 1997 / Notices 6537

linguistically isolated. According to the

1990 U.S. Census, 31.8 million persons

or 13 percent of the total U.S.

population (ages 5 and above) speak a

language other than English at home.

Almost 2 million people do not speak

English at all and 4.8 million people do

not speak English well. The 1990 U.S.

Census also found that various minority

populations and subgroups are

linguistically isolated: approximately 4

million Hispanics; approximately 1.6

million Asian and Pacific Islanders;

approximately 282,000 Blacks; and

approximately 77,000 Native

Americans. Based on the review of the

statistics regarding linguistically

isolated households across the United

States, it has been determined that this

announcement will focus on those top

15 Metropolitan Statistical Areas in

which the largest concentration of

limited-English-proficient minority

populations reside.

In 1993, the Office of Minority Health

launched its Bilingual/Bicultural

Service Demonstration Grant Program to

specifically address the barriers that

limited-English-proficient minority

populations encounter when accessing

health services. Besides the social,

cultural and linguistic barriers, which

significantly affect the delivery of

adequate health care, there are other

factors that contribute to the poor health

status of limited-English-proficient

minorities. These factors include:

• Inadequate number of health care

providers and other health care

professionals skilled in culturally

competent and linguistically

appropriate delivery of services;

• Scarcity of trained interpreters at

the community level;

• Deficiency of knowledge about

appropriate mechanisms to address

language barriers in health care settings;

• Lack of culturally appropriate

community health prevention programs;

• Absence of effective partnerships

between major mainstream provider

organizations and limited-Englishproficient minority communities;

• Low economic status;

• Lack of health insurance; and

• Organizational barriers.

Today, more and more people are

receiving their health services through

managed care—the integration of

financing, management, and the

delivery of health services, with

providers taking on financial risk (OMH,

Closing The Gap, Mar/Apr 1996). The

Health Care Financing Administration

(HCFA) is the largest purchaser of

managed care in the country. According

to HCFA’s 1995 Medicaid Managed Care

Enrollment Report, more than 11.6

million Medicaid beneficiaries are

enrolled in Medicaid managed care

plans. With this increased focus on

providing health care service delivery

via managed care, it is essential that

limited-English-proficient minority

populations adequately understand the

intricacies of the managed care system.

To make informed decisions, the

target population will need to

understand various concepts: for

example, what managed care means,

what are managed care entities, what

types of managed care plans exist and

what are the differences, what are the

pros and cons of a managed care system,

how to access services in a managed

care setting, what is a provider network,

and what are the rights of the client. For

this information to be effective, it will

need to be provided in linguistic and

culturally sensitive and comprehensive

formats appropriate for diverse

populations.

It is essential that health care

providers, health care professionals and

other staff (managed care or nonmanaged care) become informed about

their diverse clientele from a linguistic,

cultural, and medical perspective. By

becoming culturally competent, health

care providers can encourage this

vulnerable population to more

confidently access and receive

appropriate health care.

Definitions

For purposes of this grant

announcement, the following

definitions apply:

Cultural Competency—A set of

interpersonal skills that allow

individuals to increase their

understanding and appreciation of

cultural differences and similarities

within, among and between groups.

This requires a willingness and ability

to draw on community-based values,

traditions and customs, and to work

with knowledgeable persons of and

from the community in developing

focused interventions, communications

and other supports. (Orlandi, Mario A.,

1992.)

Health Care Facility—A public

nonprofit facility that has an established

record for providing a full range of

health care services to a targeted,

limited-English-proficient, racial and

ethnic minority community. Facilities

providing only screening and referral

activities are not included in this

definition. A health care facility may be

a hospital, outpatient medical facility,

community health center, migrant

health center, or a mental health center.

(Federal Register, Vol. 60, No. 71, pg

18935, April 13, 1995.)

Limited-English-Proficient

Populations—Individuals (as defined in

Minority Populations below) with a

primary language other than English

who must communicate in that language

if the individual is to have an equal

opportunity to participate effectively in

and benefit from any aid, service or

benefit provided by the health provider.

Metropolitan Statistical Area—

Comprises one or more counties

containing either a place with at least

50,000 inhabitants, or an urbanized area

and a metropolitan area of at least

100,000 (75,000 in New England).

Contiguous counties are included if they

have close social and economic links

with the area’s population nucleus.

(U.S. Bureau of the Census, Factfinder

for the Nation, CFF No. 8, March 1991.)

Minority Community-Based

Organization—A public or private

nonprofit community-based minority

organization or a local affiliate of a

national minority organization that has:

a governing board composed of 51

percent or more racial/ethnic minority

members, a significant number of

minorities in key program positions,

and an established record of service to

a racial and ethnic minority community.

Minority Populations—Asian/Pacific

Islanders, Blacks, Hispanics, and

American Indians/Alaska Natives.

(OMB Statistical Policy Directive No.

15)

Project Requirements

Each project funded under this

demonstration grant is to:

1. Carry out activities to improve the

ability of health care providers and

other health care professionals to

delivery linguistically and culturally

competent health care services to the

target population. Potential activities

may include: language and cultural

competency training and curricula

development using traditional and

innovative training models, such as CD–

ROMs, on-line formats for continuing

education; bilingual health access or

health promotion information in the

native language; and on-site

interpretation services.

2. Carry out activities to educate the

target population on the basic principles

of managed care plans and services

available within the targeted region.

Potential activities may include:

utilizing culturally and linguistically

appropriate informational/

communication technologies, such as

mass media, public service

announcements and neighborhood

outreach and electronic systems

including kiosks, as an educational tool;

and conducting forums/seminars to

promote information exchange among

managed care organizations, health care
6538 Federal Register / Vol. 62, No. 29 / Wednesday, February 12, 1997 / Notices

providers, advocacy groups, and

consumers.

3. Have an established, formal linkage

with a health care facility, prior to

submission of an application, for the

purpose of ensuring that the target

population is provided with a

continuum of support for receiving

appropriate health care services.

Evidence of an established linkage

should include signed letters of

agreement written specifically to

address the proposed projects and

relevant activities.

4. Have clearly defined and

documented roles for the applicant

(minority community-based

organization), the health care facility

and any other primary entity relevant to

the proposed model.

5. Develop an evaluation plan to

assess process and outcome data.

Use of Grant Funds

Budgets of up to $100,000 total costs

(direct and indirect) per year may be

requested to cover costs of: personnel,

consultants, supplies, equipment, and

grant-related travel. Funds may not be

used for medical treatment,

construction, building alterations, or

renovations. All budget requests must

be fully justified in terms of the

proposed goals and objectives and

include a computational explanation of

how costs were determined.

Criteria for Evaluating Applications

Review of Applications: Applications

will be screened upon receipt. Those

that are judged to be incomplete,

nonresponsive to the announcement or

nonconforming will be returned without

comment. Each organization may

submit no more than one proposal

under this announcement. If an

organization submits more than one

proposal all will be deemed ineligible

and returned without comment.

Accepted applications will be reviewed

for technical merit in accordance with

PHS policies. Applications will be

evaluated by an Objective Review Panel

chosen for their expertise in minority

health and managed care, and their

understanding of the unique health

problems and related issues confronted

by the limited-English-proficient, racial

and ethnic populations in the United

States.

Applicants are advised to pay close

attention to the specific program

guidelines and general and

supplemental instructions provided in

the application kit.

Application Review Criteria: The

technical review of applications will

consider the following generic factors:

Factor 1: Background (15%)

Adequacy of: demonstrated

knowledge of the problem at the local

level; demonstrated need within the

proposed community and target

population; demonstrated support and

established linkages in order to conduct

proposed model; and extent and

documented outcome of past efforts/

activities with the target population.

Factor 2: Goals and Objectives (15%)

Delineation of specific objectives

which are consistent with the goals of

the program, and are measurable and

outcome-oriented.

Factor 3: Methodology (35%)

Comprehensiveness of proposed work

plan and specific activities for each

objective. Adequacy of the time line in

relation to the objectives and program

evaluation. Extent to which the

applicant demonstrates access to the

target population. Adequacy of the

established linkages to provide the

services. Delineation and clarity of

defined roles for the applicant and the

linked health care facility.

Factor 4: Evaluation (20%)

Thoroughness, feasibility and

appropriateness of the evaluation design

from a methodological and data

collection perspective. Extent to which

the design allows a generalized

conclusion regarding the outcomes in

achieving the goals and objectives of the

project. Potential for replication in other

health care settings for the target

population.

Factor 5: Management Plan (15%)

Capability of the applicant

organization for program management

and evaluation of the project. Evidence

of capabilities would be adequacy of:

proposed management, frontline and

evaluation staff qualifications or

requirements of ‘‘to be hired’’ staff;

proposed staff level of effort; and

background and experience of proposed

staff relevant to proposed activities.

Award Criteria

Funding decisions will be determined

by the Deputy Assistant Secretary of

Minority Health, Office of Minority

Health and will take under

consideration: the recommendations/

ratings of the review panels, geographic

and race/ethnicity distribution, and

health problem areas having the greatest

impact on minority health. Consistent

with the Congressional intent of Public

Law 101–527, section 1707(c)3, special

consideration will be given to projects

targeting Asian, American Samoan, and

other Pacific Islander populations.

Special consideration will also be given

to projects proposed to be implemented

in Empowerment Zones/Empowerment

Communities.

Reporting and Other Requirements

General Reporting Requirements

A successful applicant under this

notice will submit: (1) an annual

progress report and Financial Status

Report, and (2) a final project report and

Financial Status Report in the format

established by the Office of Minority

Health, in accordance with provisions of

the general regulations which apply

under ‘‘Monitoring and Reporting

Program Performance,’’ 45 CFR Part 74,

Subpart J, with the exception of State

and local governments to which 45 CFR

Part 92, Subpart C reporting

requirements apply.

Provision of Smoke-Free Workplace and

Non-use of Tobacco Products by

Recipients of PHS Grants

The Public Health Service strongly

encourages all grant recipients to

provide a smoke-free workplace and to

promote the nonuse of all tobacco

products. In addition, Public Law 103–

227, the Pro-Children Act of 1994,

prohibits smoking in certain facilities

(or in some cases, any portion of a

facility) in which regular or routine

education, library, day care, health care

or early childhood development

services are provided to children.

Public Health System Reporting

Requirements

This program is subject to Public

Health Systems Reporting Requirements

which have been approved by the Office

of Management and Budget under No.

0937–0195. Under these requirements, a

community-based nongovernmental

applicant must prepare and submit a

Public Health System Impact Statement

(PHSIS). The PHSIS is intended to

provide information to State and local

health officials to keep them apprised of

proposed health services grant

applications submitted by communitybased nongovernmental organizations

within their jurisdictions.

Community-based, nongovernmental

applicants are required to submit, no

later than the Federal due date for

receipt of the application, the following

information to the head of the

appropriate state and local health

agencies in the area(s) to be impacted:

(a) a copy of the face page of the

applications (SF 424), (b) a summary of

the project (PHSIS), not to exceed one

page, which provides: (1) a description

of the population to be served, (2) a

summary of the services to be provided,
Federal Register / Vol. 62, No. 29 / Wednesday, February 12, 1997 / Notices 6539

(3) a description of the coordination

planned with the appropriate State or

local health agencies. Copies of the

letters forwarding the PHSIS to these

authorities must be contained in the

application materials submitted to the

Office of Minority Health.

State Reviews

This program is subject to the

requirements of EO 12372. 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. The application kit to be

made available under this notice will

contain a listing of States which have

chosen to set up a review system and

will include a State Single Point of

Contact (SPOC) in the State for review.

Applications (other than federally

recognized Indian tribes) should contact

their SPOCs as early as possible to alert

them to the prospective applications

and receive any necessary instructions

on the State process. For proposed

projects serving more than one State, the

applicant is advised to contact the SPOC

of each affected State. The due date for

State process recommendations is 60

days after the application deadline by

the Office of Minority Health’s Grants

Management Officer. The Office of

Minority Health does not guarantee that

it will accommodate or explain its

responses to State process

recommendations received after that

date. (See ‘‘Intergovernmental Review of

Federal Programs,’’ Executive Order

12372, and 45 CFR Part 100 for a

description of the review process and

requirements.)

OMB Catalog of Federal Domestic

Assistance

The OMB Catalog of Federal Domestic

Assistance Number for the Bilingual and

Bicultural Service Demonstration

Program is 93.105.

Dated: January 23, 1997.

Clay E. Simpson, Jr.,

Deputy Assistant Secretary for Minority

Health.

[FR Doc. 97–3522 Filed 2–11–97; 8:45 am]

BILLING CODE 4160–17–M

Agency for Toxic Substances and

Disease Registry

Citizens Advisory Committee on Public

Health Service Activities and Research

at Department of Energy (DOE) Sites:

Hanford Health Effects Subcommittee

In accordance with section 10(a)(2) of

the Federal Advisory Committee Act

(Pub. L. 92–463), the Agency for Toxic

Substances and Disease Registry

(ATSDR) and the Centers for Disease

Control and Prevention (CDC) announce

the following five meetings.

Name: Citizens Advisory Committee on

Public Health Service Activities and

Research at DOE Sites: Hanford Health

Effects Subcommittee (HHES).

Dates: February 20, 1997. February 21,

1997, 9:30 a.m.–12:30 p.m.

Times: 9 a.m.–5 p.m.; 6:30 p.m.–8:30 p.m.

Place: Red Lion Hotel/Jantzen Beach, 909

N. Hayden Island Drive, Portland, Oregon

97217. Same Location.

Tel: 503/283–4466.

Fax: 503/283–4743.

Dates: May 8, 1997, May 9, 1997, 9:30

a.m.–3:30 p.m.

Times: 9 a.m.–5 p.m., 6:30 p.m.–8:30 p.m.

Place: Cavanaugh’s at Columbia Center,

1101 Columbia Center Boulevard,

Kennewick, Washington 99336. Same

Location.

Tel: 509/783–0611.

Fax: 509/735–3087.

Dates: July 24, 1997. July 25, 1997, 9:30

a.m.–3:30 p.m.

Times: 9 a.m.–5 p.m., 6:30 p.m.–8:30 p.m.

Place: Marines’ Memorial Club, 609 Sutter

Street (at Mason), San Francisco, California

94102.

Tel: 415/673–6672.

Fax: 415/441–3649.

Dates: October 9, 1997. October 10, 1997,

9:30 a.m.–3:30 p.m.

Times: 9 a.m.–5 p.m., 6:30 p.m.–8:30 p.m.

Place: Coeur d’Alene Inn, West 414

Appleway, Coeur d’Alene, Idaho 83814.

Same Location.

Tel: 208/765–3200.

Fax: 208/664–1962.

Dates: December 11, 1997. December 12,

1997, 9:30 a.m.–3:30 p.m.

Times: 9 a.m.–5 p.m., 6:30 p.m.–8:30 p.m.

Place: Madison Hotel, 515 Madison Street,

Seattle, Washington 98104. Same Location

Tel: 206/583–0300.

Fax: 206/624–8125.

Status: Open to the public, limited only by

the space available. The meeting rooms

accommodate approximately 150 people.

Background

A Memorandum of Understanding

(MOU) was signed in October 1990 and

renewed in November 1992 between

ATSDR and DOE. The MOU delineates

the responsibilities and procedures for

ATSDR’s public health activities at DOE

sites required under sections 104, 105,

107, and 120 of the Comprehensive

Environmental Response,

Compensation, and Liability Act

(CERCLA or ‘‘Superfund’’). These

activities include health consultations

and public health assessments at DOE

sites listed on, or proposed for, the

Superfund National Priorities List and

at sites that are the subject of petitions

from the public; and other healthrelated activities such as epidemiologic

studies, health surveillance, exposure

and disease registries, health education,

substance-specific applied research,

emergency response, and preparation of

toxicological profiles.

In addition, under an MOU signed in

December 1990 with DOE, the

Department of Health and Human

Services (HHS) has been given the

responsibility and resources for

conducting analytic epidemiologic

investigations of residents of

communities in the vicinity of DOE

facilities, workers at DOE facilities, and

other persons potentially exposed to

radiation or to potential hazards from

non-nuclear energy production and use.

HHS has delegated program

responsibility to CDC.

Purpose

This subcommittee is charged with

providing advice and recommendations

to the Director, CDC, and the

Administrator, ATSDR, regarding

community, American Indian tribes,

and labor concerns pertaining to CDC’s

and ATSDR’s public health activities

and research at this DOE site. Activities

shall focus on providing a forum for

community, American Indian Tribal,

and labor interaction and serve as a

vehicle for community concern to be

expressed as advice and

recommendations to CDC and ATSDR.

Matters To Be Discussed

Agenda items include: ATSDR’s

proposed medical monitoring program,

ATSDR’s planning for an exposure

subregistry program, and solicitations of

subcommittee concerns to be addressed

by ATSDR and CDC. There will also be

updates from the Inter-tribal Council on

Hanford Health Projects, and reports

from the following Work Groups:

Outreach/Special Populations, Public

Health Activities, and Health Studies.

This notice is being published less

than 15 days prior to the meeting due

to an administrative delay.

Agenda items are subject to change as

priorities dictate.

Contact Person for More Information:

Linda A. Carnes, Health Council

Advisor, ATSDR, E–28, 1600 Clifton

Road, NE., Atlanta, Georgia 30333,

telephone 404/639–0730, FAX 404/639–

0759.

Dated: February 5, 1997.

Carolyn J. Russell,

Director, Management Analysis and Services

Office, Centers for Disease Control and

Prevention (CDC).

[FR Doc. 97–3472 Filed 2–11–97; 8:45 am]

BILLING CODE 4163–70–P